학술논문
Successful resuscitation with thrombolysis of a patient suffering fulminant pulmonary embolism after recent intracerebral haemorrhage.
Document Type
Academic Journal
Author
Koroneos A; Department of Pulmonary and Critical Care Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece. KORONEOS@hotmail.com; Koutsoukou A; Zervakis D; Politis P; Sourlas S; Pagoni E; Roussos C
Source
Publisher: Elsevier/north-Holland Biomedical Press Country of Publication: Ireland NLM ID: 0332173 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0300-9572 (Print) Linking ISSN: 03009572 NLM ISO Abbreviation: Resuscitation Subsets: MEDLINE
Subject
Language
English
ISSN
0300-9572
Abstract
We report the life-saving administration of thrombolysis during cardiopulmonary resuscitation in a patient with recent intracerebral haemorrhage. A 53-year-old male with intracerebral haemorrhage was admitted to the intensive care unit. On the 24th day of treatment he suffered cardiac arrest with pulseless electrical activity. Transoesophageal echocardiography was performed during ongoing cardiopulmonary resuscitation. Thrombi in the right heart cavities with excessive right ventricular dysfunction confirmed the diagnosis of fulminant pulmonary embolism. Permanent restoration of a spontaneous rhythm was feasible only after administration of systemic thrombolysis with recombinant tissue plasminogen activator. Neurological examination and a computed tomogram of the brain did not show rebleeding. We conclude that under extreme circumstances absolute contraindications to thrombolysis should be weighed against the potential benefit.