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Thrombolysis during cardiopulmonary resuscitation should be addressed in guidelines for pulmonary embolism: reply
Abstract
Dr Koracevic raised an interesting point, suggesting that thrombolysis should be recommended in patients with PE who present with cardiac arrest. Indeed, if caused by PE, cardiac arrest is indicating the highest risk of early death. And resuscitation is no longer considered an important contraindication to thrombolytic treatment.1 The problem is in diagnosing PE in the setting of cardiac arrest. Thrombolytic treatment was suggested to increase the chances of survival in unselected patients with cardiac arrest. However, encouraging preliminary reports and a metaanalysis of eight trials including 926 patients2 were not confirmed by a large multicentre study. In fact, the TROICA trial was discontinued in April 2006 after enrolling over 1000 patients because the preliminary data analysis indicated that it would be unlikely to demonstrate the superiority of tenecteplase over placebo during cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest.3 Importantly, the study was not stopped due to safety issues; the intracranial haemorrhage rate was within the expected range for fibrinolytic treatment.
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Research works printed but not linked: 6
- Keuper, 2007, Resuscitation, 73, 189, 10.1016/j.resuscitation.2006.08.030 · doi:10.1016/j.resuscitation.2006.08.030
- Li, 2006, Resuscitation, 70, 31, 10.1016/j.resuscitation.2005.11.016 · doi:10.1016/j.resuscitation.2005.11.016
- Stadlbauer, 2006, The American journal of cardiology, 97, 305, 10.1016/j.amjcard.2005.08.045 · doi:10.1016/j.amjcard.2005.08.045
- 2008, Current opinion in critical care, 14, 292, 10.1097/MCC.0b013e3282fb2ddf · doi:10.1097/mcc.0b013e3282fb2ddf
- Abu-Laban, 2002, New England Journal of Medicine, 346, 1522, 10.1056/NEJMoa012885 · doi:10.1056/nejmoa012885
- van der Wouw, 1997, Journal of the American College of Cardiology, 30, 780, 10.1016/S0735-1097(97)00218-0 · doi:10.1016/s0735-1097(97)00218-0
Cited by
Coutance, G., Cauderlier, E., Ehtisham, J., Hamon, M., & Hamon, M. (2011) · Critical Care · doi:10.1186/cc10119 · Cited by 294
Venous thromboembolism in the ICU: main characteristics, diagnosis and thromboprophylaxis
Minet, C., Potton, L., Bonadona, A., Hamidfar-Roy, R., Somohano, C. A., Lugosi, M., Cartier, J.-C., Ferretti, G., Schwebel, C., & Timsit, J.-F. (2015) · Critical Care · doi:10.1186/s13054-015-1003-9 · Cited by 270
Bamber, L., Muston, D., McLeod, E., Guillermin, A., Lowin, J., & Patel, R. (2015) · Thrombosis Journal · doi:10.1186/s12959-015-0051-3 · Cited by 42
Jugrin, A. V., Ustyugova, A., Urbich, M., Sunderland, T., & Lamotte, M. (2015) · Thrombosis and Haemostasis · doi:10.1160/th14-12-1027 · Cited by 11
Metadata
- Authors
- Torbicki, A., Perrier, A., & Konstantinides, S.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-10-24
- Volume
- 29
- Issue
- 24
- Pages
- 3067-3068
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W4251433429
- Cited by
- 272
- References
- 0
- FWCI
- 29.26
- Type
- journal article
- Language
- en
- Open access
- closed
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- Torbicki, A., Perrier, A., & Konstantinides, S. (2008). Thrombolysis during cardiopulmonary resuscitation should be addressed in guidelines for pulmonary embolism: reply. European Heart Journal. https://doi.org/10.1093/eurheartj/ehn475
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