Editor – Hamera et al. reported the successful cardiopulmonary resuscitation (CPR)
of a 47-year-old patient with out-of-hospital cardiac arrest (OHCA) after administration
of intravenous tissue plasminogen activator (t-PA) [
[1]
]. This well-written case report relights the topic on systemic thrombolysis during
CPR. Thrombolytics may rapidly induce reduction of plasma viscosity by cleavage of
fibrinogen [
- Hamera J.A.
- et al.
Systemic thrombolysis for refractory cardiac arrest due to presumed myocardial infarction.
Am J Emerg Med. 2020; https://doi.org/10.1016/j.ajem.2020.07.053
[2]
]. Under the restricted conditions of ongoing CPR thrombolysis enhances microcirculation,
improves coronary perfusion and most notably ameliorates cerebral reperfusion [
[3]
]. Good neurologic outcome after administration of thrombolytic agents during CPR
has been previously reported [
[4]
,
[5]
].Keywords
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References
- Systemic thrombolysis for refractory cardiac arrest due to presumed myocardial infarction.Am J Emerg Med. 2020; https://doi.org/10.1016/j.ajem.2020.07.053
- Blood viscosity during thrombolytic therapy with anistreplase in acute myocardial infarction.Am J Cardiol. 1993; 71: 14-18
- Thrombolysis using plasminogen activator and heparin reduces cerebral no-reflow after resuscitation from cardiac arrest: an experimental study in the cat.Intensive Care Med. 1996; 22: 1214-1223
- Thrombolytic therapy after cardiac arrest and its effect on neurological outcome.Resuscitation. 2002; 52: 63-69
- Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospital cardiac arrest.Resuscitation. 2004; 61: 123-129
- Fibrinopeptide A: a marker of acute coronary thrombosis.Circulation. 1985; 71: 912-918
- Activation of blood coagulation after cardiac arrest is not balanced adequately by activation of endogenous fibrinolysis.Circulation. 1995; 92: 2572-2578
Article Info
Publication History
Published online: August 24, 2020
Accepted:
August 9,
2020
Received:
August 5,
2020
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2020 Elsevier Inc. All rights reserved.
