Thrombolytic treatment of acute myocardial infarction after out-of-hospital cardiac arrest
| Autor: | Markku Kuisma, Ari Alaspää, Matti Mänttäri, Per H. Rosenberg, Ville Voipio |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Utstein Style medicine.medical_specialty Resuscitation Time Factors medicine.medical_treatment Streptokinase Population Myocardial Infarction Emergency Nursing Suburban Health Electrocardiography Fibrinolytic Agents Internal medicine Intensive care medicine Humans Myocardial infarction Cardiopulmonary resuscitation education Finland Retrospective Studies education.field_of_study business.industry Urban Health Thrombolysis medicine.disease Cardiopulmonary Resuscitation Patient Discharge Heart Arrest Survival Rate Treatment Outcome Anesthesia Blood Circulation Emergency Medicine Cardiology Female Emergency Service Hospital Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Resuscitation. 49:251-258 |
| ISSN: | 0300-9572 |
| DOI: | 10.1016/s0300-9572(00)00372-5 |
| Popis: | Objective: To investigate the safety and efficacy of thrombolytic treatment for an acute myocardial infarction (AMI) immediately after resuscitation in the out-of-hospital setting. Design: Retrospective. Setting: A middle-sized urban city (population 540 000) served by a single emergency medical system using a tiered response with physicians in field. Patients and methods: Sixty-eight patients with an initial diagnosis of AMI who received thrombolytic treatment in an out-of-hospital setting after cardiac arrest and cardiopulmonary resuscitation (CPR) between January 1st 1994 and December 31st 1998. An ECG and the myocardial enzymes (CK, CK-MB, Troponin-T) were used to diagnose AMI. Myocardial reperfusion was assessed by resolution of the ST-segment elevation. Side effects and complications were studied. The quality of secondary survival was evaluated. The Utstein style was used for a uniform style of reporting the cardiac arrest data. Results: The accuracy of prehospital diagnosis was found to be excellent. Retrospective analysis revealed that thrombolytic therapy had been appropriately administered in 64 (94%) of the 68 patients actually treated. Reperfusion was achieved in 71% of the patients. Haemorrhagic complications were few, and included intracranial haemorrhage (one patient), gastrointestinal bleeding (two patients), bleeding from the puncture site (one patient) and epistaxis (one patient). The incidence of hypotension during streptokinase infusion was 22%. Sixty-three (93%) of the patients were admitted alive to the hospital, with 36 subsequently surviving to discharge. Conclusions: Thrombolytic treatment is a safe and effective treatment in AMI even after out-of-hospital cardiopulmonary resuscitation. |
| Databáze: | OpenAIRE |
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