Journals / Respiratory Case Reports / 2020 / Cilt: 9 - Sayı: 2

A Case of Massive Pulmonary Thromboembolism in Cardiac Arrest and Tenecteplase Use

Kardiyak Arrestle Seyreden ve Tenekteplaz Kullanılan bir Masif Pulmoner Tromboemboli Olgusu

Pages
60–65
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

In the present case, as no alternative drugs were available, tenecteplase had to be used.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Pulmonary thromboembolisms occur mostly in the lower extremity veins.
📊
Key Findings & Data:Electrocardiography (ECG) shows right ventricular overload findings, V1-4 T negativity, Q1 pattern in V1, complete or incomplete right bundle branch block and accompanying S1Q3T3.
💡
Conclusion & Impact:In the present case, as no alternative drugs were available, tenecteplase had to be used.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Pulmonary thromboembolisms occur mostly in the lower extremity veins. Sudden occlusions of the main pulmonary bed may result in cardiac decompensation. Electrocardiography (ECG) shows right ventricular overload findings, V1-4 T negativity, Q1 pattern in V1, complete or incomplete right bundle branch block and accompanying S1Q3T3. Emergency and rapid treatment can be life-saving. Streptokinase and alteplase administration lasts for hours while tenecteplase administration is in the form of push. This is vital in patients requiring immediate interventions, where minutes can be critical. It also reduces the waiting time of the responsible doctor and loss of labor during the administration of risky drugs, and enables the patient to return to normal in a shorter time. Although there have been many studies in the literature addressing this subject, the available data is insufficient, since there is no indication for use in our country. In the present case, as no alternative drugs were available, tenecteplase had to be used.

Özet

Pulmoner tromboemboli daha çok alt ekstremite venlerinden kaynaklanmaktadır. Ana pulmoner yatağın aniden tıkanması kardiyak dekompansasyona neden olabilir. Elektrokardiyografi (EKG)de sağ ventrikül yüklenme bulguları olan V1-4 T negatifliği, V1’de QR paterni, komplet veya inkomplet sağ dal bloğu ve S1Q3T3 görülebilir. Acil ve hızlı tedavi hayat kurtarıcı olabilmektedir. Streptokinaz ve alteplaz verilişi saatler sürerken tenekteplaz verilişi puşe şeklinde olmaktadır. Bu da dakikaların önemli olduğu acil müdahale gerektiren durumlarda hayati önem arzetmektedir. Ayrıca riskli ilaçların uygulanması esnasında sorumlu doktorun hasta başında bekleme süresini ve iş gücü kaybını kısaltmaktadır. Hastanın daha kısa sürede normale dönmesini sağlamaktadır. Bu konuda literatürde çok sayıda çalışma olmasına rağmen ülkemizde kullanım endikasyonu olmadığından verilerimiz yetersizdir. Bu olguda alternatif ilaçlar elde olmadığı için tenekteplaz kullanılmak zorunda kalınmıştır.

🔖

Cite This Article

YILMAZ, Y. A., GÜLHAN, M. (2020). A Case of Massive Pulmonary Thromboembolism in Cardiac Arrest and Tenecteplase Use. Respiratory Case Reports, Cilt: 9 - Sayı: 2, 60–65. https://ajindex.com/articles/302399

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (12)

  1. Porres-Aguilar M, Jiménez D. Risk adapted management of acute pulmonary embolism in women. Thromb Res 2019
  2. 181(supll 1):S29-S32. [CrossRef] 2. Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, et al. 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society. Eur Respir J 2019
  3. pii: 1901647. [CrossRef] 3. Umut S, Saryal SB. Türk toraks derneği pulmoner tromboembolizm tanı ve tedavi uzlaşı raporu. 2015. 4. Kasım CG. Ferda K, Hayriye K. İlaç İndeksi. Nobel Tıp 2012. 5. Jerjes-Sánchez C. Thrombolysis in Pulmonary Embolism. Springer 2015. [CrossRef] 6. Uçar EY. Update on thrombolytic therapy in acute pulmonary thromboembolism. Eurasian J Med 2019
  4. [CrossRef] 7. Semba CP, Sugimoto K, Razavi MK. Alteplase and tenecteplase: applications in the peripheral circulation. Tech Vasc Interv Radiol 2001
  5. [CrossRef] 8. Sze DY, Carey MB, Razavi MK. Treatment of massive pulmonary embolus with catheter-directed tenecteplase. J Vasc Interv Radiol 2001
  6. [CrossRef] 9. Guillermin A, Yan DJ, Perrier A, Marti C. Safety and efficacy of tenecteplase versus alteplase in acute coronary syndrome: a systematic review and meta-analysis of randomized trials. Arch Med Sci 2016
  7. [CrossRef] 10. Meyer G, Vicaut E, Danays T, Agnelli G, Becattini C, Beyer-Westendorf J, et al. Fibrinolysis for patients with intermediate-risk pulmonary embolism. N Engl J Med 2014
  8. [CrossRef] 11. Kline JA, Nordenholz KE, Courtney DM, Kabrhel C, Jones AE, Rondina MT, et al. Treatment of submassive pulmonary embolism with tenecteplase or placebo: cardiopulmonary outcomes at 3 months: multicenter double-blind, placebo-controlled randomized trial. J Thromb Haemost. 2014
  9. [CrossRef] 12. Becattini C, Agnelli G, Salvi A, Grifoni S, Pancaldi LG, Enea I, et al. Bolus tenecteplase for right ventricle dysfunction in hemodynamically stable patients with pulmonary embolism.Throm Res 2010
  10. e82-6. [CrossRef] 13. Agrawal A, Kamila S, Donepudi A, Premchand R. Tenecteplase compared with streptokinase and heparin in the treatment of pulmonary embolism: an observational study. J Drug Assess 2017
  11. [CrossRef] 14. Shukla AN, Thakkar B, Jayaram AA, Madan TH, Gandhi GD. Efficacy and safety of tenecteplase in pulmonary embolism. J Thromb Thrombolysis 2014
  12. [CrossRef] 15. Spöhr F, Arntz HR, Bluhmki E, Bode C, Carli P, Chamberlain D, et