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Which Thrombolytic Dose Should be Given to Which Patients with Massive Pulmonary Thromboembolism? Two Cases Report
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Case Report
VOLUME: 16 ISSUE: 3
P: 128-134
December 2018

Which Thrombolytic Dose Should be Given to Which Patients with Massive Pulmonary Thromboembolism? Two Cases Report

J Turk Soc Intens Care 2018;16(3):128-134
DOI: 10.4274/tybd.33255
Behiye Deniz Kosovalı
Asiye Yavuz
Fatma İrem Yeşiler
Ahmet Eskiocak
Mustafa Kemal Bayar
1. Ankara Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yoğun Bakım Bilim Dalı, Ankara, Türkiye
No information available.
No information available
Received Date: 15.01.2017
Accepted Date: 05.07.2017
Publish Date: 03.12.2018
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ABSTRACT

Massive pulmonary thromboembolism (PTE) is a condition characterized by sudden onset of dyspnea, hypotension, right ventricular failure findings, presyncope or syncope and cardiac arrest which must be diagnosed and treated immediately. Massive PTE is an emergent and serious clinical condition with high morbidity and mortality rates. Besides close observation and monitorization during the treatment, due to severe hypoxemia often the need for mechanical ventilation, it is appropriate to follow-up in the intensive care units. According to the massive PTE algorithm in hemodynamically unstable patients, for diagnostic purposes the bedside echocardiography shows right ventricular dysfunction and if not contraindicated thrombolytic therapy must begin immediately. It is an appropriate approach to select the given thrombolytic therapy dose according to the characteristics of the patient and the disease. Two cases of massive PTE admitted to the emergency department due to dyspnea, angina and syncope were treated successfully with different doses of thrombolytic therapy and the cases were evaluated in the light of the literature information.

Keywords: Massive pulmonary thromboembolism, thrombolytic therapy, half-dose thrombolytic, intensive care unit

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