[Rapid intravenous injection of streptokinase in a high initial dose for therapy of a fulminant pulmonary embolism (author's transl)].

As a result of the case described the administration of streptokinase in a high initial dosage of about 750,000-1,000,000 U within a few minutes appears to be effective in serious lethal pulmonary embolism. In spite of hypoxic cardiac arrest a 35-year-old female patient was reanimated successfully 20 minutes after the occurrence of pulmonary embolism on the 10th day after caesarian section. The development indicated that the high dosage of streptokinase led to lysis of the embolus and thus to perfusion of the lungs. In spite of complications haemothorax 4,000 ml, uterine haemorrhage the fibrinolytic and later the anticoagulante therapy was continued until lysis of the embolus was assumed as judged by the condition of the patient. To prevent a renewed cardiac arrest a temporary pacemaker was applied. The patient survived without evidence of a cerebral lesion. This paper wants to advocate the administration of streptokinase in "exorbitant" dosage in hopeless cases of serious pulmonary embolism of which a high percentage die. It is essential that the injection be made within a few minutes and must not be extended over the normally recommended period of time.