Rescue therapy for severe COVID-19–associated acute respiratory distress syndrome with tissue plasminogen activator: A case series
| Autor: | Michael B. Yaffe, Srinivas H Reddy, Andrew H Moraco, Hunter B. Moore, Edward Chao, Christopher D. Barrett, Matthew J. Martin, Achikam Oren-Grinberg, Elias N. Baedorf-Kassis, Marco Uribe, Ernest E. Moore, Rashi Jhunjhunwala, Annette M. Ilg, Megan L. Krajewski, Shahzad Shaefi, Daniel Talmor |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Coronavirus disease 2019 (COVID-19) Critical Illness medicine.medical_treatment Pneumonia Viral Critical Care and Intensive Care Medicine Tissue plasminogen activator Article Betacoronavirus 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Refractory Internal medicine medicine Coagulopathy Humans Thrombolytic Therapy Pandemics Aged Mechanical ventilation SARS-CoV-2 business.industry COVID-19 030208 emergency & critical care medicine Middle Aged medicine.disease Respiration Artificial Pathophysiology Pneumonia Respiratory failure Tissue Plasminogen Activator Female Surgery Coronavirus Infections Respiratory Insufficiency business medicine.drug |
| Zdroj: | Journal of Trauma and Acute Care Surgery J Trauma Acute Care Surg |
| ISSN: | 2163-0763 2163-0755 |
| DOI: | 10.1097/ta.0000000000002786 |
| Popis: | The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented stresses on modern medical systems, overwhelming the resource infrastructure in numerous countries while presenting a unique series of pathophysiologic clinical findings. Thrombotic coagulopathy is common in critically ill patients suffering from COVID-19, with associated high rates of respiratory failure requiring prolonged periods of mechanical ventilation. Here, we report a case series of five patients suffering from profound, medically refractory COVID-19-associated respiratory failure who were treated with fibrinolytic therapy using tissue plasminogen activator (tPA; alteplase). All five patients appeared to have an improved respiratory status following tPA administration: one patient had an initial marked improvement that partially regressed after several hours, one patient had transient improvements that were not sustained, and three patients had sustained clinical improvements following tPA administration. LEVEL OF EVIDENCE: Therapeutic, Level V. |
| Databáze: | OpenAIRE |
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