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Bolus thrombolytic infusion during prolonged refractory cardiac arrest of undiagnosed cause
  1. A Sheth1,
  2. P Cullinan2,
  3. V Vachharajani2,
  4. S A Conrad2
  1. 1Department of Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, USA
  2. 2Critical Care Medicine Service, Louisiana State University Health Sciences Center, Shreveport, LA, USA
  1. Correspondence to:
 Dr A Sheth
 Department of Medicine, LSU Health Sciences Center, 1501, Kings Hwy, PO Box: 213, Shreveport, LA 71130, USA; drankursheth{at}yahoo.com

Abstract

Acute myocardial infarction (AMI) and pulmonary embolism (PE) account for about 70% of cardiac arrest. Although thrombolytic therapy is an effective therapy for both AMI and PE, it is not routinely recommended during cardiopulmonary resuscitation (CPR) for fear of life threatening bleeding complications. Numerous case reports and retrospective studies have suggested a beneficial effect of thrombolytics in cardiac arrest secondary to AMI and PE; however, we present a case of successful use of bolus thrombolytics during CPR in a patient with undifferentiated cardiac arrest (undiagnosed cause) after prolonged conventional resuscitation without success.

  • ACC, American College of Cardiology
  • AHA, American Heart Association
  • AMI, acute myocardial infarction
  • CPR, cardiopulmonary resuscitation
  • PE, pulmonary embolism
  • PEA, pulseless electrical activity
  • rh-tPA, recombinant human tissue plasminogen activator
  • ROSC, return of spontaneous circulation
  • bolus thrombolytics
  • cardiac arrest
  • CPR
  • ACLS

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Footnotes

  • Competing interests: none declared

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