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[Streptokinase in severe pulmonary thromboembolism]
A C Baruzzi1, R G Terzi, F K Saraiva
1Hospital das Clínicas-UNICAMP, Campinas, SP.
Arquivos Brasileiros De Cardiologia
|November 1, 1993
Summary
Streptokinase effectively treated severe pulmonary embolism (PE) by improving hemodynamic parameters. While generally safe, one patient died from PE, and another required reinfusion for recurrence.
Area of Science:
- Cardiology
- Pulmonology
- Pharmacology
Background:
- Severe pulmonary embolism (PE) poses significant mortality risks.
- Thrombolytic therapy is a critical treatment option for acute PE.
- Assessing the efficacy and safety of streptokinase in severe PE is essential.
Observation:
- Four patients with severe PE received streptokinase via a pulmonary artery catheter.
- Dosage included an initial bolus followed by a continuous infusion over 24-72 hours.
- Hemodynamic parameters and angiograms were analyzed pre- and post-treatment.
Findings:
- Treatment led to reduced right atrial pressure, mean pulmonary pressure, and pulmonary vascular resistance.
- Cardiac output and stroke volume increased post-streptokinase infusion.
- Complete lysis occurred in two patients, partial in one; one patient died from PE, and one experienced recurrence requiring reinfusion.
Implications:
- Streptokinase demonstrates hemodynamic benefits in severe PE management.
- Early intervention appears crucial for optimal outcomes.
- The intrapulmonary catheter approach showed no severe bleeding complications.