Clin Exp Emerg Med.  2022 Mar;9(1):47-53. 10.15441/ceem.21.073.

Short-term effects of fibrinolytic therapy on the hemodynamic parameters of patients with intermediate- and high-risk pulmonary embolism

Affiliations
  • 1Department of Emergency Medicine, Balikesir University School of Medicine, Balikesir, Turkey
  • 2Department of Emergency Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey
  • 3Department of Emergency Medicine, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
  • 4Department of Pulmonary Medicine, Dokuz Eylul University School of Medicine, Izmir, Turkey

Abstract


Objective
We aimed to determine the effect of fibrinolytic therapy on hemodynamic parameters at 4 hours after treatment and bleeding complications in patients with intermediate- and high-risk pulmonary embolism.
Methods
This single-center, retrospective, cohort study included patients with intermediate- and high-risk pulmonary embolism treated with fibrinolytics. Their demographic and clinical characteristics, complications, and vital signs at the initiation of and 4 hours after fibrinolytic therapy were evaluated. The primary outcome was the change in the patients’ vital signs at 4 hours after fibrinolytic therapy, compared by the Mann-Whitney U-test.
Results
Seventy-nine patients were included in this study. The systolic and diastolic blood pressures of the high-risk group at 4 hours after fibrinolytic therapy were higher than those at the initiation of fibrinolytic therapy (80 mmHg vs. 99 mmHg, P = 0.029; 49 mmHg vs. 67 mmHg, P = 0.011, respectively). In the intermediate-risk group, the oxygen saturation increased (94% vs. 96%, P = 0.004) and pulse rate decreased (104 beats/min vs. 91 beats/min, P < 0.001).
Conclusion
Blood pressure at 4 hours after fibrinolytic therapy increased in patients with high-risk pulmonary embolism. Also, oxygen saturation and pulse rate improved in intermediate-risk patients.

Keyword

Pulmonary embolism; Thrombolytic therapy; Blood pressure
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