Which Thrombolytic Dose Should be Given to Which Patients with Massive Pulmonary Thromboembolism? Two Cases Report

Kosovali B. D., Yavuz A., Yesiler F. I., Eskiocak A., BAYAR M. K.

TURKISH JOURNAL OF INTENSIVE CARE-TURK YOGUN BAKIM DERGISI, cilt.16, sa.3, ss.128-134, 2018 (ESCI) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 16 Sayı: 3
  • Basım Tarihi: 2018
  • Doi Numarası: 10.4274/tybd.33255
  • Dergi Adı: TURKISH JOURNAL OF INTENSIVE CARE-TURK YOGUN BAKIM DERGISI
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.128-134
  • Anahtar Kelimeler: Massive pulmonary thromboembolism, thrombolytic therapy, half-dose thrombolytic, intensive care unit, TISSUE-PLASMINOGEN ACTIVATOR, ANTITHROMBOTIC THERAPY, PROLONGED INFUSION, EMBOLISM, MANAGEMENT, GUIDELINES, SOCIETY
  • Ankara Üniversitesi Adresli: Evet

Özet

Massive pulmonary thromboembolism (PTE) is a condition characterized by sudden onset of dyspnea, hypotension, right ventricular failure findings, presyncope or syncope and cardiac arrest which must be diagnosed and treated immediately. Massive PTE is an emergent and serious clinical condition with high morbidity and mortality rates. Besides close observation and monitorization during the treatment, due to severe hypoxemia often the need for mechanical ventilation, it is appropriate to follow-up in the intensive care units. According to the massive PTE algorithm in hemodynamically unstable patients, for diagnostic purposes the bedside echocardiography shows right ventricular dysfunction and if not contraindicated thrombolytic therapy must begin immediately. It is an appropriate approach to select the given thrombolytic therapy dose according to the characteristics of the patient and the disease. Two cases of massive PTE admitted to the emergency department due to dyspnea, angina and syncope were treated successfully with different doses of thrombolytic therapy and the cases were evaluated in the light of the literature information.