High-dose bolus injection of urokinase. Use during cardiopulmonary resuscitation for massive pulmonary embolism.

Bolus administration of high-dose thrombolytic agents has been reported for the treatment of acute pulmonary embolism. We describe the case of a 60-year-old woman who suffered a massive pulmonary embolism with cardiopulmonary arrest 21 h after an exploratory laparotomy. After 20 min of unsuccessful cardiopulmonary resuscitation (CPR), a bolus of 2,000,000 U of urokinase was injected via a peripheral vein.

[Acute intracranial subarachnoid hemorrhage following repeated spinal anesthesia].

Three hours after spinal anaesthesia, a previously healthy 71-year-old man developed a lethal intracranial subarachnoid haemorrhage that was very likely due to rupture of a pre-existing aneurysm. Three weeks previously the patient had undergone an operation for which spinal anaesthesia had been administered uneventfully. The question is raised whether there was a causal relationship between the haemorrhage and the spinal anaesthesia; this is discussed in the light of similar cases previously published.

[Successful treatment of a fulminant pulmonary embolism using a high-dose bolus injection of urokinase during cardiopulmonary resuscitation].

Experience has shown that the bolus injection of streptokinase during resuscitation in case of fulminant pulmonary embolism considerably improves the prognosis. In the case presented here a 64-year old female patient with a fulminant pulmonary embolism was injected with 2 x 1,000,000 I.U.

[Monitoring of respiratory failure in polytraumatized patients with pulmonary contusion (author's transl)].

In polytraumatized patients, pulmonary contusion complicated by pneumonia is associated with a high risk of fatality. The effects of both contusion and bacterial infection on pulmonary function can be estimated early by measuring the parameters PAPd-PCWP, pulmonary shunt volume and maximal PaO2 following FiO2 = 1.0 for 20 min.