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USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM.

Year 2019, Volume: 10 Issue: 1, 17 - 20, 01.01.2019
https://doi.org/10.33706/jemcr.550556

Abstract

Introduction: We are presenting
6 patients who suffered a cardiac arrest (CA) for suspected pulmonary embolism.
Before establishing a definitive diagnosis, advanced life support (ALS)
algorithm was initiated. Urokinase dosed as 15.000 UI/kg (weight) was
administered initially, followed by 4.400 UI/Kg for 12 hours as a continuous
intravenous perfusion. Two patients presented absolute contraindications for fibrinolytic
therapy, however only one patient presented a major hemorrhagic complication.
Global mortality rate was 83%.

Case report: We present 6 cases
of patients with CA due to MPE
who were treated with high doses of urokinase during cardiopulmonary resuscitation
and later admitted to the Intensive Care Unit (ICU).





Conclusion: Our observations suggest that the clinical suspected MPE with CA can also be
one of the recommended applications of thrombolysis with high-dose bolus
injection of thrombolytic with efficacy.

References

  • 1. Hess EP, Campbell RL, White RD. Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin. Resuscitation 2007; 72: 200–6.
  • 2. Pokorna M, Necas E, Skripsky R, Kratochvil J, Andrlik M, Franek O. How accurately can the etiology of cardiac arrest be established in an out-of-hospital setting? Analysis by “concordance in diagnosis crosscheck tables”. Resuscitation 2011; 82: 391–7.
  • 3. Bergum D, Nordseth T, Mjolstad OC, Skogvoll E, Haugen BO. Causes of in-hospital cardiac arrest incidences and rate of recognition. Resuscitation 2015; 87: 63–8.
  • 4. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. European Heart Journal 2014; 35: 3033–80.
  • 5. Böttiger BW, Arntz HR, Chamberlain DA, Bluhmki E, Belmans A, Danays T, et al. TROICA Trial Investigators; European Resuscitation Council Study Group. Thrombolysis during Resuscitation for Out-of-Hospital Cardiac Arrest. N Engl J Med 2008; 359(25); 2651-62.
  • 6. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with STelevation myocardial infarction-- executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 2004; 110: 588-636.
  • 7. Tejerina E, Esteban A, Fernández-Segoviano P, María Rodríguez-Barbero J, Gordo F, Frutos-Vivar F, et al. Clinical diagnoses and autopsy findings: Discrepancies in critically ill patients. Crit Care Med 2012; 40: 842–6.
  • 8. Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132 (18 Suppl 2) : S315-67. M F Hazinski MF, M Shuster M, et al. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132: S313-S314
  • 9. Borloz MP, Frohna WJ, Phillips CA, Antonis MS. Emergency department focused bedside echocardiography in massive pulmonary embolism. J Emerg Med 2011; 41: 658–60.
  • 10. Chatterjee S, Chakraborty A, Weingberg I, Kadakia M, Wilensky RL, Sardar P, et al. Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage. JAMA 2014; 311: 2414-21.
Year 2019, Volume: 10 Issue: 1, 17 - 20, 01.01.2019
https://doi.org/10.33706/jemcr.550556

Abstract

References

  • 1. Hess EP, Campbell RL, White RD. Epidemiology, trends, and outcome of out-of-hospital cardiac arrest of non-cardiac origin. Resuscitation 2007; 72: 200–6.
  • 2. Pokorna M, Necas E, Skripsky R, Kratochvil J, Andrlik M, Franek O. How accurately can the etiology of cardiac arrest be established in an out-of-hospital setting? Analysis by “concordance in diagnosis crosscheck tables”. Resuscitation 2011; 82: 391–7.
  • 3. Bergum D, Nordseth T, Mjolstad OC, Skogvoll E, Haugen BO. Causes of in-hospital cardiac arrest incidences and rate of recognition. Resuscitation 2015; 87: 63–8.
  • 4. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. European Heart Journal 2014; 35: 3033–80.
  • 5. Böttiger BW, Arntz HR, Chamberlain DA, Bluhmki E, Belmans A, Danays T, et al. TROICA Trial Investigators; European Resuscitation Council Study Group. Thrombolysis during Resuscitation for Out-of-Hospital Cardiac Arrest. N Engl J Med 2008; 359(25); 2651-62.
  • 6. Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with STelevation myocardial infarction-- executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction). Circulation 2004; 110: 588-636.
  • 7. Tejerina E, Esteban A, Fernández-Segoviano P, María Rodríguez-Barbero J, Gordo F, Frutos-Vivar F, et al. Clinical diagnoses and autopsy findings: Discrepancies in critically ill patients. Crit Care Med 2012; 40: 842–6.
  • 8. Neumar RW, Shuster M, Callaway CW, Gent LM, Atkins DL, Bhanji F, et al. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132 (18 Suppl 2) : S315-67. M F Hazinski MF, M Shuster M, et al. 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2015; 132: S313-S314
  • 9. Borloz MP, Frohna WJ, Phillips CA, Antonis MS. Emergency department focused bedside echocardiography in massive pulmonary embolism. J Emerg Med 2011; 41: 658–60.
  • 10. Chatterjee S, Chakraborty A, Weingberg I, Kadakia M, Wilensky RL, Sardar P, et al. Thrombolysis for Pulmonary Embolism and Risk of All-Cause Mortality, Major Bleeding, and Intracranial Hemorrhage. JAMA 2014; 311: 2414-21.
There are 10 citations in total.

Details

Primary Language English
Journal Section Case Report
Authors

Luis Chiscano Camon This is me

Juan Carlos Ruiz Rodriguez This is me

Laura Dono Anselmo This is me

Adolf Ruiz Sanmartin This is me

Publication Date January 1, 2019
Submission Date May 11, 2018
Published in Issue Year 2019 Volume: 10 Issue: 1

Cite

APA Chiscano Camon, L., Ruiz Rodriguez, J. C., Anselmo, L. D., Sanmartin, A. R. (2019). USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM. Journal of Emergency Medicine Case Reports, 10(1), 17-20. https://doi.org/10.33706/jemcr.550556
AMA Chiscano Camon L, Ruiz Rodriguez JC, Anselmo LD, Sanmartin AR. USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM. Journal of Emergency Medicine Case Reports. January 2019;10(1):17-20. doi:10.33706/jemcr.550556
Chicago Chiscano Camon, Luis, Juan Carlos Ruiz Rodriguez, Laura Dono Anselmo, and Adolf Ruiz Sanmartin. “USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM”. Journal of Emergency Medicine Case Reports 10, no. 1 (January 2019): 17-20. https://doi.org/10.33706/jemcr.550556.
EndNote Chiscano Camon L, Ruiz Rodriguez JC, Anselmo LD, Sanmartin AR (January 1, 2019) USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM. Journal of Emergency Medicine Case Reports 10 1 17–20.
IEEE L. Chiscano Camon, J. C. Ruiz Rodriguez, L. D. Anselmo, and A. R. Sanmartin, “USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM”., Journal of Emergency Medicine Case Reports, vol. 10, no. 1, pp. 17–20, 2019, doi: 10.33706/jemcr.550556.
ISNAD Chiscano Camon, Luis et al. “USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM”. Journal of Emergency Medicine Case Reports 10/1 (January 2019), 17-20. https://doi.org/10.33706/jemcr.550556.
JAMA Chiscano Camon L, Ruiz Rodriguez JC, Anselmo LD, Sanmartin AR. USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM. Journal of Emergency Medicine Case Reports. 2019;10:17–20.
MLA Chiscano Camon, Luis et al. “USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM”. Journal of Emergency Medicine Case Reports, vol. 10, no. 1, 2019, pp. 17-20, doi:10.33706/jemcr.550556.
Vancouver Chiscano Camon L, Ruiz Rodriguez JC, Anselmo LD, Sanmartin AR. USE OF HIGH-DOSE OF UROKINASE DURING CARDIOPULMONARY RESUSCITATION FOR CLINICALLY SUSPECTED MASSIVE PULMONARY EMBOLISM. Journal of Emergency Medicine Case Reports. 2019;10(1):17-20.