A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial)

Fatovich, Daniel M; Dobb, Geoffrey; Clugston, R.

doi:10.1016/j.resuscitation.2004.01.016

Cited by 86 publications

(49 citation statements)

References 12 publications

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“…[187][188][189][190][191][192][193][194] Despite the potential to increase the risk of severe bleeding, fibrinolytics may improve survival to discharge and long-term neurological function in patients with presumed PE-induced cardiac arrest. [193][194][195][196] Emergency echocardiography may be helpful in determining the presence of thrombus or PE.…”

Section: Acls Modificationsmentioning

confidence: 99%

Part 12: Cardiac Arrest in Special Situations

Hoek¹,

Morrison²,

Shüster³

et al. 2010

Circulation

661

437

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Section: Acls Modificationsmentioning

confidence: 99%

Part 12: Cardiac Arrest in Special Situations

Hoek¹,

Morrison²,

Shüster³

et al. 2010

Circulation

661

437

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“…244,245 One study showed an increased risk of intracranial bleeding associated with the routine use of fibrinolytics during cardiac arrest (LOE 1). 245 Seven studies showed benefit from fibrinolytic therapy in the treatment of victims of cardiopulmonary arrest unresponsive to standard therapy; however, those studies had significant limitations (LOE 1 246 ; LOE 2 [247][248][249][250] ; LOE 3 251,252 ).…”

Section: Consensus On Sciencementioning

confidence: 99%

“…245 One meta-analysis of 8 retrospective cohort studies with a variety of causes of cardiac arrest (pulmonary embolism, 2 studies; myocardial infarctions, 4 studies; cardiology diseases, 1 study; and nontraumatic etiologies, 1 study) demonstrated an increased rate of ROSC, survival to discharge, and long-term neurological function with fibrinolytic, but it also showed an increased risk of severe bleeding (LOE 2). 719 Nine studies of patients with presumed pulmonary embolism or all patients with cardiopulmonary arrests showed improvement with fibrinolysis in ROSC and admission to the hospital or ICU, but no improvement in survival to discharge (LOE 1 246 ; LOE 2 248,250 ; LOE 3 251 ; LOE 4 247,720 -723 ). Three studies showed good neurological function in those who survived after successful fibrinolysis during CPR (LOE 2 719 ; LOE 3 722 ; LOE 4 721 ).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 8: Advanced Life Support

Morrison¹,

Deakin²,

Morley³

et al. 2010

Circulation

411

169

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“…Early prospective controlled trials associated this technique with a low rate of complications. [29][30][31][32][33] However, subsequent larger trials have revealed no such benefit. 33,34 As a result, the current American Heart Association guidelines report no convincing evidence that the routine use of thrombolytic agents during resuscitation improves survival rates.…”

Section: Discussionmentioning

confidence: 99%

A Case of Survival after Cardiac Arrest and 3½ Hours of Resuscitation

Nusbaum¹,

Bassett²,

Gregorič³

et al. 2014

Texas Heart Institute Journal

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I n general, outcomes after cardiac arrest remain poor, especially in patients with risk factors such as unwitnessed arrest, unfavorable initial rhythm, older age, and prolonged resuscitation without return of spontaneous circulation (ROSC). 1-4Guidelines therefore exist for terminating resuscitative efforts in cases of cardiac arrest that are deemed futile. 5,6 Nonetheless, successful resuscitation and good recovery after prolonged arrest have been documented. [7][8][9][10] As the field of cardiopulmonary resuscitative medicine evolves, new techniques are being implemented to improve outcomes in patients who are in cardiac arrest. We present an example of how recent research findings in resuscitative medicine improved one patient's chances of survival. Case ReportIn June 2011, a 40-year-old white man with a history of hypertension, hyperlipidemia, obesity (body mass index, 34.9 kg/m 2 ), and chronic tobacco use presented with presyncopal symptoms. Severe pressure-like chest pain had started 24 hours previously and had completely resolved spontaneously 12 hours before the current presentation. An electrocardiogram (ECG) showed persistent ST-segment elevation in the anterior leads. He was hemodynamically well compensated. Initial laboratory reports showed cardiac troponin I elevation to a level above 50 ng/mL.The patient was not a candidate for primary percutaneous coronary intervention (PCI) for STEMI because of his delayed presentation, the complete resolution of his chest pain, and the development of anterior Q waves on his ECG. He was admitted to the cardiovascular care unit (CCU) and was treated conservatively with antiplatelet, anticoagulant, and antiarrhythmic therapy.The next morning, a coronary angiogram revealed an occluded proximal left anterior descending coronary artery, an occluded obtuse marginal branch, and a diffusely diseased right coronary artery. On hospital day 3, a positron emission tomographic viability scan showed only minimal viable myocardium and a large area of scar tissue; therefore, the patient was not a candidate for revascularization. He remained hemodynamically stable in the CCU and was subsequently transferred to the medicine floor.At 5:37 am on hospital day 5, the patient experienced sustained ventricular tachycardia and then lost consciousness. He had no spontaneous respirations, and neither the carotid nor femoral pulses could be palpated. His airway was secured, and positive-pressure ventilation was initiated. Simultaneously, cardiopulmonary resuscita-

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A pilot randomised trial of thrombolysis in cardiac arrest (The TICA trial)

Cited by 86 publications

References 12 publications

Part 12: Cardiac Arrest in Special Situations

Part 12: Cardiac Arrest in Special Situations

Part 8: Advanced Life Support

A Case of Survival after Cardiac Arrest and 3½ Hours of Resuscitation

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