Frequency of complications of cardiopulmonary resuscitation after thrombolysis during acute myocardial infarction

Scholz, K. H.; Tebbe, Ulrich; Herrmann, Christoph S.; J, Wojcik; Lingen, Renate; Chemnitius, Jörg-Michael; Brune, S.; Kreuzer, H

doi:10.1016/0002-9149(92)90494-j

Cited by 89 publications

(36 citation statements)

References 12 publications

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“…Scholz et al [17] found no bleeding complications directly related to CPR in 16 patients after successful resuscitation -but in only four of them systemic thrombolysis was performed. Van Campen et al [19] also evaluated the safety of thrombolytic therapy in Values are expressed as n (%) or median (range).…”

Section: Discussionmentioning

confidence: 99%

“…In the nonthrombolysis group we observed major bleeding complications in seven of 133 patients (5%, 95% confidence interval 1-9%) (patient nos [14][15][16][17][18][19][20]. In patient 14 (CPR duration 12 min) the X-ray revealed left-sided fluidopneumothorax without signs of tension as major complication.…”

Section: Patients With Major Bleeding Complicationsmentioning

confidence: 89%

“…Only some case reports and small case series provided data regarding the safety and efficacy of systemic thrombolytic treatment in patients who suffered cardiac arrest caused by AMI [13][14][15][16][17][18][19][20]. Some authors consider CPR to be a relative contraindication for thrombolysis, irrespective of the duration of CPR, whilst others consider only prolonged CPR a contraindication.…”

Section: Introductionmentioning

confidence: 99%

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Major bleeding complications after cardiopulmonary resuscitation: impact of thrombolytic treatment

Kürkciyan¹,

Meron²,

Sterz³

et al. 2003

Journal of Internal Medicine

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Objective. The risk of bleeding complications caused by thrombolysis in patients with cardiac arrest and prolonged cardiopulmonary resuscitation is unclear. We evaluate the complication rate of systemic thrombolysis in patients with out-of-hospital cardiac arrest caused by acute myocardial infarction, especially in relation to duration of cardiopulmonary resuscitation. Design. The study was designed as retrospective cohort study, the risk factor being systemic thrombolysis and the end-point major haemorrhage, defined as life-threatening and/or need for transfusion. Over 10.5 years, emergency cardiac care data, therapy, major haemorrhage and outcome of 265 patients with acute myocardial infarction admitted to an emergency department after successful cardiopulmonary resuscitation were registered. Results. We observed major haemorrhage in 13 of 132 patients who received thrombolysis (10%, 95% confidence interval 5-15%), five of these survived to discharge, none died because of this complication. Major haemorrhage occurred in seven of 133 patients in whom no thrombolytic treatment had been given (5%, 95% confidence interval 1-9%), two of these survived to discharge. Taking into account baseline imbalances between the groups, the risk of bleeding was slightly increased if thrombolytics were used (odds ratio 2.5, 95% confidence interval 0.9-7.4) but this was not significant (P ¼ 0.09). There was no clear association between duration of resuscitation and bleeding complications (z for trend ¼ 1.52, P ¼ 0.12). Survival was not significantly better in patients receiving thrombolysis (odds ratio 1.6, 0.9-3.0, P ¼ 0.12). Conclusions. Bleeding complications after cardiopulmonary resuscitation are frequent, particularly in patients with thrombolytic treatment, but do not appear to be related to the duration of resuscitation. In the light of possible benefits on outcome, thrombolytic treatment should not be withheld in carefully selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Patients With Major Bleeding Complicationsmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Major bleeding complications after cardiopulmonary resuscitation: impact of thrombolytic treatment

Kürkciyan¹,

Meron²,

Sterz³

et al. 2003

Journal of Internal Medicine

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show abstract

“…Two series comprising a total of 102 patients treated with CPR for durations ranging from 4 -120 min, however, found no increased incidence of major or minor bleeding complications [33,34]. Thus, in the absence of obvious chest wall trauma or anoxic brain injury (the latter would theoretically increase the risk of intracranial hemorrhage), CPR should not be considered a contraindication to thrombolysis.…”

Section: Cardiopulmonary Resuscitationmentioning

confidence: 99%

Thrombolytic therapy for acute myocardial infarction

Estess¹,

Moliterno²

2001

Cathet Cardio Intervent

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“…Die ursprungliche Ablehnung der Lyse nach Reanimation mit Herzdruckmassage wurde weitgehend revidiert, nachdem mehrere Arbeiten gezeigt hatten, daB damit kein erhohtes Mortalitats-and Blutungsrisiko vergesellschaftet ware [5,6,17,20,22]. Nach einem 10tagigen Aufenthalt auf der Intensivstation wurde der Patient auf eine kardiologische Normalstation transferiert.…”

Section: Introductionunclassified

Beidseitige akute retrobulbäre Raumforderung im Rahmen einer Thrombolysetherapie bei Myokardinfarkt — ein Fallbericht

Vécsei

Domanovits²,

Kircher

et al. 1997

Spektrum Augeheilkd

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Frequency of complications of cardiopulmonary resuscitation after thrombolysis during acute myocardial infarction

Cited by 89 publications

References 12 publications

Major bleeding complications after cardiopulmonary resuscitation: impact of thrombolytic treatment

Major bleeding complications after cardiopulmonary resuscitation: impact of thrombolytic treatment

Thrombolytic therapy for acute myocardial infarction

Beidseitige akute retrobulbäre Raumforderung im Rahmen einer Thrombolysetherapie bei Myokardinfarkt — ein Fallbericht

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