[Thrombolysis during cardiopulmonary resuscitation--own clinical observations--case report]

Thrombolytic therapy is contraindicated in the course of cardiopulmonary resuscitation (CPR). If the primary cause of cardiac arrest is myocardial infarction or massive pulmonary embolism, fibrynolysis may be life-saving. We present a case report of a woman admitted to the Intensive Care Unit with cardiac arrest with symptoms suggesting myocardial infarction or pulmonary embolism. After unsuccessful conservative CPR a single dose of 500000 IU streptase was administered. Heart action returned 10 minutes later, nevertheless the patient needed mechanical ventilation and circulatory system stabilization therapy (catecholamines) in doses dependent on haemodynamic parameters. During hospitalization she regained consciousness. She presented no neurological defects and after 5 days was discharged to the Cardiology Department. Electrocardiography and echocardiography done after successful resuscitation was specific to infero-lateral myocardial infarction. Although safety and efficacy of thrombolytic therapy at resuscitation was extensively studied, this procedure is still controversial. Till now, there is no data concerning thrombolytic treatment in such clinical situations, which are based on clinical trials, and such treatment is introduced in dramatic situations, as a last, lifesaving option.