Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=28413515
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Outcome of out-of-hospital cardiac arrest after fibrinolysis with reteplase in
comparison to the return of spontaneous circulation after cardiac arrest score in
a geographic region without emergency coronary intervention
#MMPMID28413515
Luiz T
; Wilhelms A
; Madler C
; Pollach G
; Haaff B
; Grüttner J
; Viergutz T
Exp Ther Med
2017[Apr]; 13
(4
): 1598-1603
PMID28413515
show ga
Coronary occlusion and pulmonary embolism are responsible for the majority of
cases of out-of-hospital cardiac arrest (OHCA). Despite previous favourable
results of pre-hospital fibrinolysis in cases of OHCA, the benefit could not be
confirmed in a large controlled study using the fibrinolytic tenecteplase. For
reteplase (r-PA), there are hardly any data regarding pre-hospital fibrinolysis
during ongoing resuscitation. The present study reported results using r-PA
therapy in a German physician-supported Emergency Medical Services system. The
data of OHCA patients who received pre-hospital fibrinolytic treatment with r-PA
after an individual risk/benefit assessment were retrospectively analysed. To
assess the effectiveness of this approach, the rate of patients with a return of
spontaneous circulation (ROSC) was compared with the corresponding figure that
was calculated with the help of the RACA (ROSC after cardiac arrest) score. The
RACA algorithm predicts the probability of ROSC based on data from the German
Resuscitation Registry. Further outcome data comprised hospital discharge rate
and neurologic status at discharge. From 2001 to 2009, 43 patients (mean age,
58.5 years; 65.1% male; 58.1% ventricular fibrillation) received r-PA. Of these,
20 patients (46.5%) achieved ROSC, compared to a probability of 49.8% according
to the RACA score (P=0.58). A total of 8 patients (18.6%) were discharged alive,
including 5 (11.2%) with a good neurological outcome. For the analysed small
patient collective, pre-hospital r-PA did not offer any benefits with regard to
the ROSC rate. Further analyses of larger patient numbers on a nationwide
registry basis are recommended.
free
free
free
