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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Rapid IJ (aka Easy Internal Jugular Cannulation)

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lunes, 8 de agosto de 2016

Controlled thrombolysis of submassive PE

PulmCrit (EM Crit)
PulmCrit - January 18, 2016 - By Josh Farkas 
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  • "The ideal approach to dosing alteplase for thrombolysis of PE remains unclear.
  • Patients’ response to alteplase varies depending on their balance of pro- vs. anti-fibrinolytic modulators.
  • A slow peripheral alteplase infusion (e.g. 1 mg/hour infusion) could allow monitoring of the patient’s response to thrombolysis throughout the procedure, with discontinuation if there were excessive fibrinolysis or bleeding.
  • Available data suggests that quarter-dose alteplase is effective. Based on data from >1,000 patients undergoing catheter-directed thrombolysis of PE or DVT, slow infusions of alteplase are safe.
  • Controlled thrombolysis using a slow 25-mg alteplase infusion with protocoled monitoring might offer patients the benefit of lytic therapy with an extremely low risk of severe hemorrhage."
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