Thursday, December 18, 2008

Thrombolysis during Resuscitation...just published

I remembered one of my first patients with AMI, Post arrest and CPR was done. He had no internal bleeding after CPR, no absolute CI to SK. The question was raised: CPR as a relative CI to thrombolytic therapy. Nice residency days....
Thrombolysis during Resuscitation
ORIGINAL ARTICLE, Thrombolysis during Resuscitation for Out-of-Hospital CardiacArrest, B.W. Böttiger and Others, Abstract Full Text PDF PPT Slide SetIn this randomized, double-blind, multicenter trial, adult patients with witnessed out-of-hospital cardiac arrest were assigned to receive either tenecteplase (thrombolytic agent) or placebo during resuscitation. The use of heparin, clopidogrel, ticlodipine, and aspirin were discouraged and the use of glycoprotein IIb/IIIa inhibitors was not permitted in this study. The researchers observed no significant differences between the tenecteplase and placebo groups in the efficacy end points that were evaluated, including the primary end point of 30-day survival and the secondary end points of return of spontaneous circulation, hospital admission, 24-hour survival, survival to hospital discharge, and neurologic outcome. However, the researchers do state the following:“Our findings do not suggest that thrombolytic therapy should be withheld in patients with cardiac arrest if the primary pathologic condition is known to be responsive to such treatment.” B.W. Böttiger and Others, Original Article, “Thrombolysis during Resuscitation for Out-of-Hospital Cardiac Arrest.”

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