EBQ:PEAPETT Study: Difference between revisions
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*PE risks: unprovoked PE: 70%, smoker: 43%, cancer history/active: 35%, estrogen or testosterone therapy: 26%, prothrombotic: 26%, concomitant DVT: 65%, previous VTE: 30% | *PE risks: unprovoked PE: 70%, smoker: 43%, cancer history/active: 35%, estrogen or testosterone therapy: 26%, prothrombotic: 26%, concomitant DVT: 65%, previous VTE: 30% | ||
*100% had D-dimer elevation, troponin elevation, BNP elevation, RV enlargement, and RV hypokinesia | *100% had D-dimer elevation, troponin elevation, BNP elevation, RV enlargement, and RV hypokinesia | ||
===Inclusion Criteria=== | ===Inclusion Criteria=== | ||
*Cardiopulmonary arrest with PEA secondary to massive pulmonary embolism | *Cardiopulmonary arrest with PEA secondary to massive pulmonary embolism | ||
===Exclusion Criteria=== | ===Exclusion Criteria=== | ||
None | *None | ||
==Interventions== | ==Interventions== | ||
Revision as of 08:08, 16 May 2020
Sharifi M et al.. "Pulseless electrical activity in pulmonary embolism treated with
thrombolysis (from the “PEAPETT” study)". American Journal of Emergency Medicine. 2016. 34:1963-1967.PubMed Full text
Clinical Question
Does low dose tissue plasminogen activator (tPA) improve survival in patients with pulseless electrical activity and cardiopulmonary arrest due to confirmed pulmonary embolism?
Conclusion
Rapid administration of 50mg of tPA is safe and effective in achieving ROSC in patients with PEA due to massive pulmonary embolism leading to increased survival and reduction of pulmonary artery pressures
Major Points
Approximately 8%-13% of unexplained cardiac arrests are due to a massive pulmonary embolism (PE)[1]. Current ACLS and AHA guidelines suggest that thrombolytics should be considered in cardiac arrests that are thought to be secondary to a PE. This study was created to understand better the usage of tPA, efficacy, and safety in cardiopulmonary arrest in confirmed PE.
This study was a single-center study of 23 patients on whom the group was consulted.
Study Design
- Single-center study, unblinded
- N=23 patients with confirmed pulmonary embolism, cardiac arrest with PEA
- Study investigators were consulted on 23 patients
- This cohort was then retrospectively identified via the medical record and followed prospectively on clinical and echocardiographic outcomes *Surviving patients were followed up 3 weeks after discharge and every 6 months after until 22 ± 3 months
- Surviving patients were screened for DVT at the second office visit, and for DVT or PE if there was enough suspicion throughout follow up time
Population
- All recruited from a single US center
Patient Demographics
- Men 39% (n=9)
- Age 72 ± 5
- PE risks: unprovoked PE: 70%, smoker: 43%, cancer history/active: 35%, estrogen or testosterone therapy: 26%, prothrombotic: 26%, concomitant DVT: 65%, previous VTE: 30%
- 100% had D-dimer elevation, troponin elevation, BNP elevation, RV enlargement, and RV hypokinesia
Inclusion Criteria
- Cardiopulmonary arrest with PEA secondary to massive pulmonary embolism
Exclusion Criteria
- None
Interventions
Outcomes
Primary Outcome
Secondary Outcomes
Subgroup analysis
Criticisms & Further Discussion
External Links
See Also
Funding
References
- ↑ Hess EP, Campbell RL, White RD. Epidemiology, trends, and outcome of out-of hospital cardiac arrest of non-cardiac origin. Resuscitation 2007;72:200–6