One of the main supporterrs of lysis during arrest is Bottiger in Germany.
He is about to start (or may have already started) an RCT looking at lysis
for out-of-hospital arrests in the EMS based service in Germany. It is
apparently being backed by the European Resus Council.
His previous work has shown that thrombolysed patients have significantly
more chance of gaining return of spontaneous circulation, and of survivng to
cardiac ICU. There was no difference in survival to discharge. His results
have been supported by several smaller studies, but his has been the only
prospective one. Interestingly, in all the papers, there were no life
threatening adverse outcomes as a result of the CPR in conjunction with
thrombolysis.
Paul
|