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Editor's Correspondence
December 11/25, 2000

Thrombolysis and Pulmonary Embolism Presenting With Cardiac Arrest—Reply

Arch Intern Med. 2000;160(22):3495-3496. doi:

In reply

We would like to thank colleagues Manfredini and Gallerani for their valuable comments stressing our suggestion that systemic thrombolysis for patients with cardiac arrest caused by pulmonary embolism should be used as the first-line treatment only in selected patients. In patients with cardiac arrest caused by pulmonary embolism, it is frequently very difficult to restore spontaneous circulation. With systemic thrombolysis one might achieve better primary survival rates. This has been shown by our 2 young patients who were admitted under ongoing resuscitation and survived to hospital discharge in good neurological condition.1 We believe that without the immediate administration of thrombolytic agents, these patients would have died. Another 3 patients were stabilized initially but did not survive owing to multiple organ failure during intensive care therapy.1 Recently, we were able to discharge another 33-year-old patient in good neurological condition after the application of thrombolytic treatment during prolonged cardiopulmonary resuscitation.

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