Intravenous thrombolysis in the emergency department for the treatment of acute ischaemic stroke
| Autor: | F. Tosato, Mascagna, L. Macchini, Andrea Semplicini, M Leoni, Renzo Manara, Benetton, Achille C. Pessina, Anna Realdi, Lorenzo A. Calò, Carla Carollo, E Parotto |
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| Rok vydání: | 2008 |
| Předmět: |
Male
medicine.medical_specialty Critical Care medicine.medical_treatment Critical Care and Intensive Care Medicine Tissue plasminogen activator Brain Ischemia Brain ischemia Fibrinolytic Agents Intensive care medicine Humans Infusions Intravenous Stroke Aged Cerebral Hemorrhage business.industry General Medicine Thrombolysis Emergency department Original Articles medicine.disease Magnetic Resonance Imaging Surgery Treatment Outcome Tissue Plasminogen Activator Emergency medicine Inclusion and exclusion criteria Emergency Medicine Female business Emergency Service Hospital Tomography X-Ray Computed Fibrinolytic agent medicine.drug |
| Zdroj: | Emergency Medicine Journal : EMJ |
| ISSN: | 1472-0213 |
| Popis: | Background and aims: Thrombolytic therapy with intravenous recombinant tissue plasminogen activator (rt-PA) improves outcome in patients with ischaemic stroke treated within 3 h of symptom onset, but its extended implementation is limited. A pilot study was designed to verify whether evaluation of patients with acute ischaemic stroke and their treatment with intravenous rt-PA in the emergency department (ED), followed by transportation to a semi-intensive stroke care unit, offers a safe and effective organisational solution to provide intravenous thrombolysis to acute stroke patients when a stroke unit (SU) is not available. Methods: After checking for inclusion and exclusion criteria, ED doctors contacted the stroke team with a single page, located family members and urgently obtained computed tomography scan and laboratory tests. A stroke team investigator clinically assessed the patient, obtained written informed consent and supervised intravenous rt-PA in the ED. After treatment, the patient was transferred to the SU for rehabilitation and treatment of complications, under supervision of the same stroke team investigator. Results: 52 patients were treated with intravenous rt-PA within 3 h of symptom onset. 20 patients (38%) improved neurologically after 24 h, the number increased to 30 (58%) after one week. At 3 months 22 patients had a favourable outcome (43%). The 3-month mortality rate was 12%. Symptomatic cerebral haemorrhage was observed in two patients (4%). Conclusions: Intravenous rt-PA administration in the ED is an effective organisational solution for acute ischaemic stroke when an SU is not established. |
| Databáze: | OpenAIRE |
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