Thrombolysis during cardiopulmonary resuscitation

Abstract

Numerous experimental researches and clinical observations reveal that immediately after cardiac arrest a significant platelet activation appears which is not counterbalanced by endogenous fibrinolysis and leads to disseminated laying down of fibrin’s concrement in arteria and microclots’ formation. The process is being developed during cardiopulmonary resuscitation and extended to a post-resuscitation period. There have been some experimental works and clinical examinations revealing that treatment with heparin and thrombolysis’ application can increase the survival rate after an incident of cardiac arrest. Thrombolysis therapy becomes a new method facilitating prognosis as to patient’s health after cardiac arrest. Presently one can state undoubtedly that either fibrinolysis therapy or thrombolysis therapy is justified at suspicion of an acute pulmonary embolism contributing to patient’s hemodynamic stabilization. In the results it has been obtained hitherto that this sort of therapy, applied during cardiopulmonary resuscitation after prolonged cardiac arrest at acute coronary syndrome increases survival rate and improves patient’s neurological state during a post-resuscitation period. Full confirmation of these observations needs some further multi-centered, randomized studies of the issues under consideration. (Cardiol J 2007; 14: 24–28)