Document Detail


Effects of a single bolus of urokinase in patients with life-threatening pulmonary emboli: a descriptive trial.
MedLine Citation:
PMID:  6488499     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To evaluate hemodynamic, angiographic, and biological effects of a single bolus of urokinase, an open descriptive trial was conducted in a homogeneous group of 14 patients with acute life-threatening pulmonary emboli and without prior cardiopulmonary disease. For every patient the efficacy of the treatment was evaluated by comparing control and posttherapeutic values after the bolus injection of 15,000 IU/kg body weight urokinase (urinary source) administered in 10 min in the right atrium, followed by continuous intravenous full-dose heparin therapy. In two patients clinical status, hemodynamics, vascular obstruction, and biological (fibrinogen and plasminogen levels) parameters remained unchanged. One of these two patients died, making the mortality rate for the whole group 7%. Twelve of 14 patients showed rapid clinical improvement. Evaluation at 12 hr demonstrated significant decreases in pulmonary vascular obstruction (Miller index, 34%), total pulmonary vascular resistances (37%), and fibrinogen and plasminogen levels (41% and 40%, respectively), without any significant change in cardiac index. The hemodynamic sequential measurements performed (1,3, 6, and 12 hr) in seven of the 12 improved patients showed that the greatest percentage of the total hemodynamic improvement occurred within the first 3 hr after bolus administration of urokinase. No severe hemorrhagic complications were observed. Because of its rapid efficacy and its low cost, the bolus technique appeared particularly useful in the treatment of patients with acute life-threatening pulmonary emboli.
Authors:
P Petitpretz; G Simmoneau; J Cerrina; D Musset; M Dreyfus; M D Vandenbroek; P Duroux
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  70     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1984 Nov 
Date Detail:
Created Date:  1984-12-05     Completed Date:  1984-12-05     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  861-6     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Gas Analysis
Blood Pressure / drug effects
Emergencies
Heart Atria
Humans
Injections
Lung / blood supply
Middle Aged
Pulmonary Artery / radiography
Pulmonary Embolism / drug therapy*
Urokinase-Type Plasminogen Activator / administration & dosage*,  adverse effects,  therapeutic use
Vascular Resistance / drug effects
Chemical
Reg. No./Substance:
EC 3.4.21.73/Urokinase-Type Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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