Evaluation of Systemic Thrombolytic Treatment in the Emergency Service in Unstable and Resuscitated Patients Due to Massive Pulmonary Embolism

Year 2022, Volume: 4 Issue: 1, 3 - 7, 30.04.2022

Özlem Bilir , Alpaslan Ünlü , Filiz Taşçı , Gökhan Ersunan , İsmail Ataş

https://doi.org/10.55994/ejcc.1050495

Cited By: 1

Abstract

Background: PE accounts for 3% of out-of-hospital cardiac arrest. In this case, treating patients with thrombolysis during resuscitation has been associated with better survival.
Objective: The aim of this study is to evaluate the use of systemic thrombolytic in unstable and/or resuscitated patients who are evaluated in the red area in emergency service practice and who are diagnosed with massive pulmonary embolism with bedside examinations.
Methods: This prospective study was designed on 17 patients who were transferred as unstable to the emergency service of a tertiary hospital by Emergency Health Services and/or who needed resuscitation due to non-shockable fatal rhythm disorder on admission and who underwent systemic thrombolysis due to the diagnosis of pulmonary embolism during resuscitation.
Results: Of the 17 patients included in the study, 52.9% were discharged and improvement was detected in unstable vital findings in 47.1% patients after thrombolysis. Of the bedside examinations performed on admission, ECG showed T wave negativity at V1-4 deviations and P-pulmonale in 41.2% patients and ECHO showed right ventricle dilatation indicating right ventricle dysfunction in 82.4% patients. CTPA taken after stabilization showed thrombus at bilateral pulmonary artery in 88.2% patients.
Conclusion: Cardiopulmonary arrest caused by PE is a life-threatening condition that requires urgent systemic thrombolysis. Patients who are evaluated as unstable or in need of resuscitation in the emergency service should be diagnosed quickly as a result of examinations performed at bed-side and thrombolytic treatment should be started.

Keywords

Emergency,, Pulmonary Embolism,, Massive,, Trombolytic Treatment

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