![]() Rapid administration of 50 mg of tPA is safe and effective in restoration of spontaneous circulation in PEA due to massive PE leading to enhanced survival and significant reduction in pulmonary artery pressures.Ĭopyright © 2016 Elsevier Inc. 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. There was no recurrent venous thromboembolism or bleeding during hospitalization or at follow-up. Pulseless electrical activity (PEA) is a clinical condition characterized by unresponsiveness and lack of palpable pulse in the presence of organized cardiac electrical activity. The right ventricular/left ventricular ratio and pulmonary artery systolic pressure dropped from 1.79 ± 0.27 and 58.10 ± 7.99 mm Hg on admission to 1.16 ± 0.13 and 40.25 ± 4.33 mm Hg within 48 hours, respectively (P<. ![]() Of the 23 patients, 2 died in the hospital, and at 22 ± 3 months of follow-up, 20 patients (87%) were still alive. There was no minor or major bleeding despite chest compression. Return of spontaneous circulation occurred in 2 to 15 minutes after tPA administration in all but 1 patient. The time from initiation of cardiopulmonary resuscitation to administration of tPA was 6.5 ± 2.1 minutes. Prevention The following measures may prevent some cases of in-hospital PEA: Patients who have been on prolonged bed rest should receive deep venous thrombosis (DVT) prophylaxis. All patients received 50 mg of tPA as intravenous push in 1 minute while cardiopulmonary resuscitation was ongoing. ![]() We evaluated the outcome of low-dose systemic thrombolysis with tissue plasminogen activator (tPA) in patients presenting with PEA due to PE.ĭuring a 34-month period, we treated 23 patients with PEA and cardiopulmonary arrest due to confirmed massive PE. There is a paucity of data in the use of thrombolytic therapy in PEA and cardiopulmonary arrest due to confirmed pulmonary embolism (PE). A lack of ventricular impulse often points to the absence of ventricular contraction, but the contrary is not always true. Pulseless electrical activity (PEA) during cardiac arrest portends a poor prognosis. Pulseless electrical activity (PEA), also known as electromechanical dissociation, is a clinical condition characterized by unresponsiveness and impalpable pulse in the presence of sufficient electrical discharge. ![]()
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