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Related Experiment Videos

Pulmonary dysfunction associated with streptokinase therapy.

M D Kerstein, M F Adinolfi

    Archives of Surgery (Chicago, Ill. : 1960)
    |July 1, 1986
    PubMed
    Summary
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    Low-dose streptokinase infusion for acute femoral artery occlusion led to fatal adult respiratory distress syndrome in a lower-extremity amputee. This case highlights potential severe complications of fibrinolytic therapy.

    Area of Science:

    • Cardiovascular Medicine
    • Hematology
    • Critical Care Medicine

    Background:

    • Acute limb ischemia, such as femoral artery occlusion, poses a significant risk of limb loss and mortality.
    • Fibrinolytic therapy, using agents like streptokinase, is a treatment option for acute arterial occlusions.
    • Low-dose, continuous infusion protocols are sometimes employed to balance efficacy and reduce systemic effects.

    Observation:

    • A 66-year-old patient, a lower-extremity amputee, presented with acute femoral artery occlusion.
    • Treatment involved a percutaneous constant infusion of low-dose streptokinase (10,000 units/h).
    • After 48 hours of therapy, the patient developed adult respiratory distress syndrome (ARDS).

    Findings:

    • The patient ultimately died from the complications of ARDS.

    Related Experiment Videos

  • Postmortem examination confirmed ARDS.
  • Laboratory studies revealed significant hematological changes, including increased fibrinolytic split products, thrombocytopenia (low platelet count), and hypofibrinogenemia (low fibrinogen levels).

    • Implications:

    • This case underscores the potential for severe, life-threatening systemic complications, such as ARDS, even with low-dose fibrinolytic therapy.
    • It highlights the critical importance of vigilant monitoring for adverse events during streptokinase infusion.
    • Further research may be warranted to refine risk stratification and monitoring protocols for patients receiving fibrinolytic agents, particularly those with comorbidities.