Thrombolysis with recombinant tissue plasminogen activator during cardiopulmonary resuscitation in fulminant pulmonary embolism. A case series

Objective: To describe our outcomes using thrombolysis during the cardiopul monary resuscitation (CPR) of patients in cardiorespiratory arrest (CA) cau sed by fulminant pulmonary embolism (FPE). Design: A case series. Setting: Intensive care units of a district hospital and a referral centre. Patients : Six patients that suffered CA secondary to an FPE. Interventions: Adminis tration of recombinant tissue plasminogen activator during usual CPR manoeu vres when there was a strong suspicion of FPE. Permission for the thromboly tic therapy was sought from family members in all cases. Results: Four out of the six patients survived and remain symptom-free. The thrombolysis was not associated with any fatal complications. Conclusions: Early thrombolysi s during CPR manoeuvres for CA apparently caused by an FPE may reduce the m ortality rate among these patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.