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Management of Acute Pulmonary Embolism pp 137–146Cite as

Management of the Patient With Fulminant Pulmonary Embolism Undergoing Cardiopulmonary Resuscitation

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Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Patients with cardiac arrest after fulminant pulmonary embolism (PE) have a very poor prognosis. Conventional cardiopulmonary resuscitation (CPR) is frequently unsuccessful because it does not treat the underlying condition. Although thrombolysis is an effective therapeutic option for patients with acute PE, this treatment has traditionally been withheld during CPR because of the anticipated risk of severe hemorrhagic complications associated with chest compressions. This chapter focuses on the mechanisms of action of thrombolytic therapy during CPR after acute PE on the basis of experimental and clinical data. In fact, most data suggest a significant improvement of overall and neurological outcome in patients receiving thrombolysis during CPR after massive PE. Although the use of thrombolytics is indeed associated with an increased incidence of hemorrhagic complications in this setting, critical bleeding complications are rare and do not seem to outweigh the potential benefits of this therapeutic option. Therefore, thrombolytic therapy should not be withheld in patients suffering cardiac arrest after massive PE, particularly if conventional CPR has failed to show immediate success and other treatment options (e.g., surgical embolectomy) are not available.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Ruprecht Karls University, Heidelberg, Germany

    Fabian Spöhr MD

  2. European Resuscitation Council, Germany

    Bernd W. Böttiger MD, DEAA

  3. Department of Anesthesiology, Ruprecht Karls University, Heidelberg, Germany

    Bernd W. Böttiger MD, DEAA

Authors
  1. Fabian Spöhr MD
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  2. Bernd W. Böttiger MD, DEAA
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Editor information

Editors and Affiliations

  1. Department of Cardiology and Pulmonology, Georg August University, Goettingen, Germany

    Stavros V. Konstantinides MD (Professor of Medicine) (Professor of Medicine)

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© 2007 Humana Press Inc., Totowa, NJ

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Spöhr, F., Böttiger, B.W. (2007). Management of the Patient With Fulminant Pulmonary Embolism Undergoing Cardiopulmonary Resuscitation. In: Konstantinides, S.V. (eds) Management of Acute Pulmonary Embolism. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-287-8_11

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  • DOI: https://doi.org/10.1007/978-1-59745-287-8_11

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-644-3

  • Online ISBN: 978-1-59745-287-8

  • eBook Packages: MedicineMedicine (R0)

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