Good neurological recovery after cardiopulmonary resuscitation and thrombolysis in two old patients with pulmonary embolism

Authors: CAVALLARO, F.; SANDRONI, C.; BOCCI, M. G.; MARANO, C.

Source: Acta Anaesthesiologica Scandinavica, Volume 53, Number 3, March 2009 , pp. 400-402(3)

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Abstract:

The use of thrombolysis as an emergency treatment for cardiac arrest (CA) due to massive pulmonary embolism (MPE) has been described. However, there are no reports of successful treatment of MPE-associated CA in patients over 77 years of age. We report two cases of successful cardiopulmonary resuscitation for an MPE-associated CA in two very old women (87 and 86 years of age). In both cases, typical signs of MPE were documented using emergency echocardiography, which showed an acute right ventricle enlargement and a paradoxical movement of the interventricular septum. Emergency thrombolysis was administered during resuscitation, which lasted 45 and 21 min, respectively. Despite old age and prolonged resuscitation efforts, both patients had good neurological recovery and one of them was alive and neurologically intact 1 year later. Thrombolysis is a potentially useful therapy in MPE-associated CA. A good neurological outcome can be obtained even in very old patients and after prolonged resuscitation.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1399-6576.2008.01861.x

Affiliations: 1: Department of Anaesthesiology and Intensive Care, Intensive Care Unit, Catholic University School of Medicine, Policlinico `A. Gemelli', Rome, Italy

Publication date: 2009-03-01