Document Detail


Thrombolytic treatment of acute myocardial infarction after out-of-hospital cardiac arrest.
MedLine Citation:
PMID:  11719118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate the safety and efficacy of thrombolytic treatment for an acute myocardial infarction (AMI) immediately after resuscitation in the out-of-hospital setting. DESIGN: Retrospective. SETTING: A middle-sized urban city (population 540000) served by a single emergency medical system using a tiered response with physicians in field. PATIENTS AND METHODS: Sixty-eight patients with an initial diagnosis of AMI who received thrombolytic treatment in an out-of-hospital setting after cardiac arrest and cardiopulmonary resuscitation (CPR) between January 1st 1994 and December 31st 1998. An ECG and the myocardial enzymes (CK, CK-MB, Troponin-T) were used to diagnose AMI. Myocardial reperfusion was assessed by resolution of the ST-segment elevation. Side effects and complications were studied. The quality of secondary survival was evaluated. The Utstein style was used for a uniform style of reporting the cardiac arrest data. RESULTS: The accuracy of prehospital diagnosis was found to be excellent. Retrospective analysis revealed that thrombolytic therapy had been appropriately administered in 64 (94%) of the 68 patients actually treated. Reperfusion was achieved in 71% of the patients. Haemorrhagic complications were few, and included intracranial haemorrhage (one patient), gastrointestinal bleeding (two patients), bleeding from the puncture site (one patient) and epistaxis (one patient). The incidence of hypotension during streptokinase infusion was 22%. Sixty-three (93%) of the patients were admitted alive to the hospital, with 36 subsequently surviving to discharge. CONCLUSIONS: Thrombolytic treatment is a safe and effective treatment in AMI even after out-of-hospital cardiopulmonary resuscitation.
Authors:
V Voipio; M Kuisma; A Alaspää; M Mänttäri; P Rosenberg
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Resuscitation     Volume:  49     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2001 Jun 
Date Detail:
Created Date:  2001-11-23     Completed Date:  2002-01-03     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  251-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Intensive Care, Helsinki University Central Hospital, P.O. Box 340, Helsinki, FIN-00029 HUS, Finland. ville.voipio@helsinki.fi
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MeSH Terms
Descriptor/Qualifier:
Blood Circulation / drug effects
Cardiopulmonary Resuscitation
Electrocardiography
Emergency Service, Hospital*
Female
Fibrinolytic Agents / therapeutic use*
Finland
Heart Arrest / complications*,  diagnosis,  mortality,  therapy*
Humans
Male
Myocardial Infarction / complications*,  diagnosis,  drug therapy*,  mortality
Patient Discharge
Retrospective Studies
Streptokinase / therapeutic use
Suburban Health
Survival Rate
Time Factors
Treatment Outcome
Urban Health
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.-/Streptokinase

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