Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, P.R. China.
Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, Hubei, P.R. China.
BMC Cardiovasc Disord. 2024 Jul 27;24(1):387. doi: 10.1186/s12872-024-04012-9.
Cerebrovascular events during thrombolysis in cardiac arrest (CA) caused by pulmonary embolism (PE) is a life-threatening condition. However, the balance between cerebrovascular events and thrombolytic therapy in PE-induced CA remains a great challenge.
In this study, we reported three unique cases regarding main concerns surrounding cerebrovascular events in thrombolytic therapy in PE-induced CA.
The patient in the case 1 treated with thrombolysis during CPR and finally discharged neurologically intact. The patient in the case 2 received delayed thrombolysis and died eventually. The patient in the case 3 was contraindicated to thrombolysis due to the complication of subarachioid hemorrahage and died within days.
Our case series highlights three proposed approaches to consider before administering thrombolysis as a treatment option in PE-induced CA patients: (1) prolonging the resuscitation, (2) administering thrombolysis promptly, and (3) ruling out cerebrovascular events.
肺栓塞（PE）导致的心搏骤停（CA）患者溶栓过程中发生脑血管事件是一种危及生命的情况。然而，PE 导致的 CA 中溶栓治疗与脑血管事件之间的平衡仍然是一个巨大的挑战。
本研究报道了三个关于溶栓治疗中与 PE 导致的 CA 相关的主要关注的脑血管事件的独特病例。
病例 1 的患者在 CPR 期间接受溶栓治疗，最终神经功能完整出院。病例 2 的患者接受了延迟溶栓治疗，最终死亡。病例 3 的患者由于蛛网膜下腔出血的并发症而被排除在溶栓治疗之外，几天后死亡。
我们的病例系列强调了在 PE 导致的 CA 患者中考虑溶栓治疗作为治疗选择之前需要考虑的三种方法：（1）延长复苏时间，（2）及时给予溶栓治疗，（3）排除脑血管事件。
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