Which out of hospital cardiac arrest patients should be thrombolysed?

TROICA (Thrombolysis for Out of Hospital Cardiac Arrest), a large double-blinded randomized placebo controlled trial showed no difference in 30-day mortality between thrombolysis and placebo group [3]. Overall, currently the risk to benefit ratio of thrombolysis in cardiac arrest remains poorly unde...

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Bibliographic Details
Published inThe American journal of emergency medicine Vol. 34; no. 5; pp. 916 - 917
Main Authors McCartney, Ben, McQuail, Paula, Garrett, Peter
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2016
Elsevier Limited
Subjects
Adult
Cardiac arrest
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - methods
Clinical Decision-Making
Combined Modality Therapy
CPR
Embolism, Paradoxical - complications
Embolism, Paradoxical - diagnosis
Embolism, Paradoxical - therapy
Embolisms
Emergency
Emergency medical care
Female
Fibrinolytic Agents - therapeutic use
Foramen Ovale, Patent - complications
Foramen Ovale, Patent - diagnosis
Foramen Ovale, Patent - therapy
Heart attacks
Humans
Mortality
Out-of-Hospital Cardiac Arrest - etiology
Out-of-Hospital Cardiac Arrest - therapy
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Summary:TROICA (Thrombolysis for Out of Hospital Cardiac Arrest), a large double-blinded randomized placebo controlled trial showed no difference in 30-day mortality between thrombolysis and placebo group [3]. Overall, currently the risk to benefit ratio of thrombolysis in cardiac arrest remains poorly understood but review of the literature suggests it tips in favor in out of hospital cardiac arrest from suspected PE, and in younger patients with suspected STEMI if given early, with heparin and aspirin, where alternative interventions are not immediately available, although further trials are required to confirm this.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2016.02.018