R.E.B.E.L.EM - january 5, 2017 - By Salim Rezaie - Peer Reviewed by Astin M
"Background: Anyone who has run a code, knows that pulseless electrical activity (PEA) during cardiac arrest has a worse prognosis compared to patients with shockable rhythms. In patients with suspected massive PE as the cause of their cardiac arrest the Advanced Cardiac Life Support (ACLS) and American Heart Association (AHA) guidelines do recommend consideration of thrombolytics. There is however, no uniform consensus on the type, dose, duration, timing, or method of administration. The current study (PEAPETT Trial) was an attempt to do exactly that...
Author Conclusion: “Rapid administration of 50mg of tPA is safe and effective in restoration of spontaneous circulation in PEA due to massive PE leading to enhanced survival and significant reduction in pulmonary artery pressures.”
Clinical Take Home Point: Although this is not the most robust evidence, it would be reasonable to consider giving 50mg IV tPA in patients with suspected or confirmed PE causing cardiac arrest."