Search

Bleeding, the serious complication of thrombolytic therapy with tissue type plasminogen activator (t-PA), is a result from lysis of fibrin in hemostatic plugs and from the systemic lytic state caused by unopposed plasmin. It suggests that structural changes resulting from incorporation of fragment X into clots promote their lysis and the attenuation of thrombolytic therapy-induced fragment X formation might reduce the risk of bleeding.

NS293 Tough J (2005) Thrombolytic therapy in acute myocardial infarction. Nursing Standard. 19, 37, 55-64. Date of acceptance: April 19 2005. Summary This article examines thrombolytic therapy, the first-line treatment [...]

Basilar artery occlusion is an infrequent disease with high morbidity and mortality. Outcome of patients with Basilar artery occlusion (BAO) treated with intravenous thrombolytic therapy is evaluated.

Predictors of lack of improvement at 24 hours after receiving alteplase and their relationship with poor outcome at 3 months are evaluated. Lack of improvement at 24 hours is associated with poor outcome of death at 3 months, is found among patients with acute stroke being treated with thrombolytic therapy.

Byline: Jan J. De Waele (1), Sebastiaan Van Cauwenberghe (1), Eric Hoste (1), Dominique Benoit (1), Francis Colardyn (1) Keywords: Heparin, therapeutic use Heparin, administration and dosage Partial thromboplastin time Monitoring Physiological, methods Abstract: Objective. To determine the correlation between activated clotting time (ACT) and activated partial thromboplastin time (aPTT) in patients receiving intravenous unfractionated heparin therapy, and the accuracy of the ACT in predicting the level of anticoagulation. Design. Paired aPTT and ACT measurements were obtained from a convenience sample of critically ill patients requiring intravenous unfractionated heparin. The aPTT was determined in the hospital laboratory and ACT measurements were performed with a portable device. Setting. The intensive care unit of Ghent University Hospital, a tertiary care facility with 54 beds. Patients and participants. Twenty-eight patients were studied prospectively a total of 105 paired samples were obtained. The indication for heparin therapy was cerebral ischemia in 8, various cardiac conditions in 10, pulmonary embolism in 3, continuous hemofiltration in 3, and peripheral arterial thrombosis in 4. Results. There was a significant correlation between aPTT and ACT. Analysis of variance showed a significant difference in ACT between different levels of anticoagulation, aPTT shorter than 60 s (group 1), aPTT 60--90 s (group 2), and aPTT longer than 90 s (group 3): 142+-16.7 s in group 1 vs. 155+-29.6 and 192+-39.1 in groups 2 and 3. Conclusions. The correlation between the aPTT and the ACT in this ICU setting is poor ACT cannot differentiate between low and therapeutic levels of anticoagulation. The use of the ACT for monitoring low to moderate doses of heparin in ICU patients cannot be recommended. Author Affiliation: (1) Intensive Care Unit, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium Article History: Received Date: 21/06/2002 Accepted Date: 13/11/2002 Article note: Electronic Publication

A comparison of aspirin and clopidogrel as an adjuvant treatment reveals that aspirin is less efficient in protecting canine coronary artery from reocclusion after thrombolysis, than clopidogrel. Clopidogrel delays or prevents reocclusion after thrombolysis by counteracting the influences of thromboxane A(2) and ADP.

Byline: K.J. Pugh (), S.B. Jureidini (), R. Ream (), P. Syamasundar Rao (), J. Dossier () Abstract: Childhood pulmonary embolism (PE) is a rare but serious condition marked by hypoxemia, shock, right-sided heart failure, and significant risk for fatality. Recommended treatment options include surgical embolectomy, anticoagulation, and thrombolysis. This report describes the successful use of recombinant tissue plasminogen activator to treat PE associated with urosepsis in a 34-day-old infant and reverse severe hemodynamic compromise. Diagnosis of proximal PE and monitoring its treatment were successfully achieved by echocardiography. Author Affiliation: () Department of Pediatrics, Division of Cardiology, Saint Louis University School of Medicine and Cardinal Glennon Children's Hospital, 1465 South Grand Boulevard, St. Louis, MO 63104, USA, US