Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospital cardiac arrest

Part 12: Cardiac Arrest in Special Situations

“…[187][188][189][190][191][192][193][194] Despite the potential to increase the risk of severe bleeding, fibrinolytics may improve survival to discharge and long-term neurological function in patients with presumed PE-induced cardiac arrest. [193][194][195][196] Emergency echocardiography may be helpful in determining the presence of thrombus or PE.…”

Part 9: Post–Cardiac Arrest Care

“…112 The use of fibrinolytics during CPR has been studied, and CPR itself does not appear to pose an unacceptable risk of bleeding. [113][114][115][116][117][118][119][120][121] Alternatively, surgical embolectomy has also been used successfully in some patients after PE-induced cardiac arrest. 117,[122][123][124][125] Mechanical thrombectomy was employed in a small case series and only one of seven patients died and pulmonary perfusion was restored in the majority (85.7%).…”

Part 10: Special Circumstances of Resuscitation

“…37,[45][46][47][48][49][50][51][52][53][54] There is no consensus on the ideal dose of thrombolytic therapy in PE-associated cardiac arrest. Contemporary examples of accelerated emergency thrombolysis dosing regimens for fulminant PE include alteplase 50 mg intravenous (IV) bolus with an option for repeat bolus in 15 minutes, or single-dose weight-based tenecteplase; thrombolytics are administered with or followed by systemic anticoagulation.…”