Document Detail


Tissue plasminogen activator for the treatment of acute pulmonary embolism. A collaborative study by the PIOPED Investigators.
MedLine Citation:
PMID:  2106408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thirteen patients with acute pulmonary embolism were treated in a randomized double-blind fashion either with recombinant tissue plasminogen activator (rt-PA) 40 to 80 mg, usually in combination with heparin, or with placebo plus heparin. The drug was administered intravenously over 40 to 90 minutes. Nine patients received rt-PA, and four received placebo. A lytic effect was observed 1.5 and three hours after the onset of therapy with rt-PA based upon elevated levels of fragment-D dimers. Among the patients who received rt-PA, there was a modest improvement of the total pulmonary resistance 1.5 hours after the start of therapy, but the angiograms showed no significant changes in two hours. After 24 hours, the lung scans showed a trend toward greater improvement with rt-PA, but the rate of improvement in comparison to control subjects was not statistically significant. Massive bleeding occurred in one patient. The observations in this study suggest that rt-PA has little effect in two hours on angiographic clot burden, but may produce some improvement in hemodynamics. The treatment, however, is not without risk.
Authors:
-
Related Documents :
8144768 - Relation between procedural activated coagulation time and outcome after percutaneous t...
7468118 - Effect of epidural versus general anaesthesia on calf blood flow.
15999048 - Recombinant human antithrombin iii restores heparin responsiveness and decreases activa...
10708078 - Evaluation of the safety and efficacy of enoxaparin and warfarin for prevention of deep...
12011968 - Flight microangiopathy in medium-to-long distance flights: prevention of edema and micr...
24257658 - Does torn discoid meniscus have effects on limb alignment and arthritic change in middl...
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  97     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1990 Mar 
Date Detail:
Created Date:  1990-04-02     Completed Date:  1990-04-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  528-33     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Aged, 80 and over
Double-Blind Method
Female
Heparin / administration & dosage,  therapeutic use
Humans
Infusions, Intravenous
Male
Middle Aged
Multicenter Studies as Topic
Placebos
Pulmonary Embolism / drug therapy*,  physiopathology,  radiography
Random Allocation
Recombinant Proteins / administration & dosage,  therapeutic use
Tissue Plasminogen Activator / administration & dosage,  therapeutic use*
Vascular Resistance
Ventilation-Perfusion Ratio
Chemical
Reg. No./Substance:
0/Placebos; 0/Recombinant Proteins; 9005-49-6/Heparin; EC 3.4.21.68/Tissue Plasminogen Activator

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


Previous Document:  The effect of complete and incomplete revascularization on exercise variables in patients undergoing...
Next Document:  Natural course of treated pulmonary embolism. Evaluation by perfusion lung scintigraphy, gas exchang...