Thrombolysis after initially unsuccessful cardiopulmonary resuscitation in presumed pulmonary embolism.

The life-saving administration of thrombolytic therapy after initially unsuccessful cardiopulmonary resuscitation (CPR) in 7 patients with presumed pulmonary embolism (PE) was reported. Seven patients who had cardiac arrest were admitted to our emergency department. The clinical diagnosis of all these patients was highly suspected with PE; therefore, 50 mg recombinant tissue plasminogen activator with 50-mL dilution was administered in a 15-minute period after initially unsuccessful CPR. Of 7 patients, 5 (71.4%) achieved return of spontaneous circulation after CPR and thrombolytic therapy, and 3 (42.9%) of 7 patients were discharged alive through successive treatments. A 90-day follow-up showed that 2 patients were neurologically intact, and 1 patient was mildly disabled. These results demonstrate that thrombolysis after initially unsuccessful CPR in presumed PE may have beneficial effects.