|Major bleeding complications in cardiopulmonary resuscitation: the place of thrombolytic therapy in cardiac arrest due to massive pulmonary embolism.|
|PMID: 12668299 Owner: NLM Status: MEDLINE|
|OBJECTIVE: Thrombolytic therapy in patients with massive pulmonary embolism (MPE) and prolonged cardiopulmonary resuscitation (CPR) is subject to debate. This study was performed to determine whether (1) thrombolytic treatment increases the risk of bleeding complications, (2) if the risk of bleeding is influenced by the duration of CPR and if (3) thrombolytic therapy improves outcome. DESIGN: Retrospective cohort study. SETTING: Emergency department of a tertiary care university hospital. PATIENTS AND METHODS: Sixty-six patients with cardiac arrest (CA) due to MPE admitted between July 1993 and December 2001. Thirty-six patients received thrombolysis (TL) and were compared with 30 patients without thrombolytic therapy. Bleeding complications were assessed by clinical evidence or autopsy. RESULTS: Major bleeding complications appear to occur more frequently in patients treated with thrombolytics (9/36 (25%) vs. 3/30 (10%)) even though the difference was statistically not significant (P=0.15). It appears that CPR duration >10 min has no adverse impact on major bleeding complications. No difference in the rate of major bleeding complications between thrombolyzed patients who had a CPR duration of </=10 or >10 min could be observed (2/8 (25%) vs. 7/28 (25%), P=0.99). In thrombolyzed patients a return of spontaneous circulation could be achieved more frequently (24/36 (67%) vs.13/30 (43%) in controls, P=0.06) and survival after 24 h was higher (19/36 (53%) vs. 7/30 (23%), P=0.01). Survival to discharge was also higher in the TL group (7/36 (19%) vs. 2/30 (7%)), but not statistically significant (P=0.15). CONCLUSION: Although severe bleeding complications tend to occur more frequently in patients undergoing TL, the benefit of this treatment might outweigh the risk of bleeding.|
|Karin Janata; Michael Holzer; Istepan Kürkciyan; Heidrun Losert; Eva Riedmüller; Branco Pikula; Anton N Laggner; Klaus Laczika|
Related Documents :
|20129389 - Immunoadsorption in the treatment of acquired haemophilia.
21033229 - Factors contributing to the failure of argon plasma coagulation hemostasis in patients ...
12695459 - Deaths associated with platelet glycoprotein iib/iiia inhibitor treatment.
16608029 - Efficacy of endoscopic clipping and long-term follow-up of bleeding dieulafoy's lesions...
20585979 - Endoscopic therapy for peptic ulcer hemorrhage: practice variations in a multi-center u...
2237719 - Preventing postoperative acute bleeding of the upper part of the gastrointestinal tract.
11346339 - Clinical and pathophysiologic correlates of 1064-nm nd:yag laser treatment of reticular...
23524219 - Triple therapy with aspirin, prasugrel and vitamin k antagonists in patients with drug ...
17018329 - A series of three sequential, randomized, controlled studies of repeated treatments wit...
|Type: Comparative Study; Journal Article|
|Title: Resuscitation Volume: 57 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2003 Apr|
|Created Date: 2003-04-01 Completed Date: 2003-07-31 Revised Date: 2009-08-25|
Medline Journal Info:
|Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland|
|Languages: eng Pagination: 49-55 Citation Subset: IM|
|Department of Emergency Medicine, Vienna General Hospital, Waehringer Guertel 18-20, 6D, A-1090, Vienna, Austria. firstname.lastname@example.org|
|APA/MLA Format Download EndNote Download BibTex|
Aged, 80 and over
Austria / epidemiology
Cardiopulmonary Resuscitation / methods*
Heart Arrest / complications, mortality, therapy*
Intracranial Hemorrhages / etiology*, mortality
Pulmonary Embolism / complications, drug therapy*, mortality
Severity of Illness Index
Thrombolytic Therapy / adverse effects*, methods
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Efficacy of CPR in a general, adult ICU.
Next Document: Improving CPR performance using an audible feedback system suitable for incorporation into an automa...