Rescue therapy for severe COVID-19-associated acute respiratory distress syndrome with tissue plasminogen activator: A case series
Rescue therapy for severe COVID-19-associated acute respiratory distress syndrome with tissue plasminogen activator: A case series
复制标题
DOI：
10.1097/ta.0000000000002786
复制
发表时间：
2020-09-01
影响因子：
3.4
通讯作者：
Yaffe, Michael B.
中科院分区：
文献类型：
--
作者：
Barrett, Christopher D.;Oren-Grinberg, Achikam;Yaffe, Michael B.
2019冠状病毒病（COVID-19）大流行给现代医疗系统带来前所未有的压力，使许多国家的资源基础设施不堪重负，同时呈现出一系列独特的病理生理临床发现。血栓性凝血病在患有COVID-19的重症患者中很常见，相关的呼吸衰竭发生率很高，需要长时间的机械通气。在这里，我们报告了一个病例系列，其中5名患者患有严重的、医学难治性COVID-19相关呼吸衰竭，他们接受了使用组织纤溶酶原激活剂（tPA;阿替普酶）的纤溶治疗。所有5例患者在tPA给药后似乎呼吸状态均有所改善：1例患者最初有明显改善，数小时后部分消退，1例患者有短暂改善，但未持续，3例患者在tPA给药后有持续的临床改善。
The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented stresses on modern medical systems, overwhelming the resource infrastructure in numerous countries while presenting a unique series of pathophysiologic clinical findings. Thrombotic coagulopathy is common in critically ill patients suffering from COVID-19, with associated high rates of respiratory failure requiring prolonged periods of mechanical ventilation. Here, we report a case series of five patients suffering from profound, medically refractory COVID-19-associated respiratory failure who were treated with fibrinolytic therapy using tissue plasminogen activator (tPA; alteplase). All five patients appeared to have an improved respiratory status following tPA administration: one patient had an initial marked improvement that partially regressed after several hours, one patient had transient improvements that were not sustained, and three patients had sustained clinical improvements following tPA administration.