Related Experiment Video
Updated: Dec 21, 2025

Microbioreactor-Based Production of Anchorage-Dependent Mesenchymal Stromal Cells Primed for Acute Respiratory Distress Syndrome
Published on: December 12, 2025
Rescue therapy for severe COVID-19-associated acute respiratory distress syndrome with tissue plasminogen activator:
Christopher D Barrett1, Achikam Oren-Grinberg, Edward Chao
1From the Division of Acute Care Surgery (C.D.B., R.J., M.B.Y.), Trauma and Surgical Critical Care, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston; Departments of Biological Engineering and Biology (C.D.B., M.B.Y.), Koch Institute for Integrative Cancer Research, Center for Precision Cancer Medicine, Massachusetts Institute of Technology, Cambridge; Department of Anesthesia (A.O.-G., A.M.I., M.L.K., D.S.T., S.S.), Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Division of Trauma and Surgical Critical Care (E.C., S.H.R., M.U.), Department of Surgery, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York; Division of Pulmonary and Critical Care (A.H.M.), Department of Medicine, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Massachusetts; Department of Surgery (M.J.M.), Scripps Mercy Hospital, San Diego, California; Department of Emergency Medicine (A.M.I.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; Department of Surgery (H.B.M., E.E.M.), University of Colorado Denver, Aurora; Department of Surgery (E.E.M.), Ernest E Moore Shock Trauma Center at Denver Health, Denver, Colorado; Division of Pulmonary, Critical Care and Sleep Medicine (E.N.B.-K.), Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented stresses on modern medical systems, overwhelming the resource infrastructure in numerous countries while presenting a unique series of pathophysiologic clinical findings. Thrombotic coagulopathy is common in critically ill patients suffering from COVID-19, with associated high rates of respiratory failure requiring prolonged periods of mechanical ventilation. Here, we report a case series of five patients suffering from profound, medically refractory COVID-19-associated respiratory failure who were treated with fibrinolytic therapy using tissue plasminogen activator (tPA; alteplase). All five patients appeared to have an improved respiratory status following tPA administration: one patient had an initial marked improvement that partially regressed after several hours, one patient had transient improvements that were not sustained, and three patients had sustained clinical improvements following tPA administration. LEVEL OF EVIDENCE: Therapeutic, Level V.
More Related Videos
Related Concept Videos
Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
Cardiopulmonary Resuscitation IV: Pharmacological Management
Cardiopulmonary Resuscitation II: ACLS Airway Management
Acute Coronary Syndrome IV: Interprofessional Care

