Fifty patients who did not respond to treatment with ACLS interventions were given the clot-buster tenecteplase, known medically as a fibrinolytic agent. Spontaneous circulation returned in 26 percent of these patients. Four percent survived and were discharged from the hospital and had normal brain function. In the group of 113 patients who received ACLS alone, 12 percent were revived, but none lived long enough to leave the hospital.
The patients who were treated with tenecteplase had been receiving ACLS measures for a mean of 30 minutes and received a mean of eight doses of standard medications.
"The study supports the use of fibrinolytic drugs in select cases of cardiac arrest where patients don't respond to standard therapy, and it reinforces the need for additional studies of this therapy," said Bozeman.
Tenecteplase is approved by the Food and Drug Administration for treating patients suffering from acute heart attacks or pulmonary embolism (blockage of an artery in the lungs that can cause heart rhythm problems). Clot-busting drugs aren't typically used in patients with cardiac arrest because of concerns that the chest compressions used during CPR could cause bleeding complications.
Several small studies, however, have suggested that clot-busting medications, in combination with CPR, may improve overall survival. Bozeman's study is the first in the United States to observe the effects of treatment with tenecteplase and with standard therapy.
Tenecteplase was developed and is marketed by Genentech Inc. of South San Francisco as TNKase