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Fibrinolysis occurred within 1.5 hours after receiv­ing rt-PA, based upon the prompt elevation of frag­ment D-dimers. The assay that was used was specific for fibrin and did not detect fibrinogen degradation products. The observed reduction of fibrinogen levels in each of three patients receiving 80 mg of rt-PA was consistent, in addition, with a systemic […]

The presence of fragment-D dimers in the blood at 1.5 and 3 hours after beginning therapy indicated the in vivo occurrence of clot lysis. Higher levels of fragment-D dimers were present 3 hours after the onset of therapy in the blood of patients who received rt-PA than in patients who received heparin alone (40±29 |xg/ml […]

VentUation/Berfusion Scans Ventilation scans and perfusion scans (V/Q scans), as well as plain chest roentgenograms were obtained before the pulmonary arteri­ogram, perfusion scans were performed again after double-blind treatment at intervals of 24 hours, 48 hours, and 7 days. All V/Q scans were obtained with wide field-of-view gamma cameras (di­ameter 38.1 cm) fitted with low-energy […]

A lthough recombinant tissue plasminogen activator would seem to have great potential for the treat­ment of acute pulmonary embolism, experience with this agent is limited, and no comparisons to placebo have been published. The purpose of the present study, therefore, was preliminarily to evaluate the efficacy of rt-PA, especially in combination with hep­arin, compared to […]

Massive Hemoptysis The initial approaches to airway support during life- threatening hemoptysis reflected practical con­cerns in the resuscitation of a drowning patient (Table 4). While either the insertion of specialized tubes and blockers or selective endotracheal intubation of the nonbleeding lung are theoretically attractive and con­sistently recommended in major reviews, the difficulty and/or impracticality of […]

The format of this interactive session provided previously unreported insights about physicians’ per­spectives of the diagnosis and management of patients with hemoptysis. Using this computerized system, a survey of clinical opinions could be combined with the educational objectives of the session, resulting in a unique opportunity to compare principles and recommendations described in medical literature […]

Massive Hemoptysis Views differed about the most common cause of fatal hemoptysis: lung cancer (29 percent), bronchi­ectasis (28 percent), tuberculosis (23 percent), myce­toma (11 percent), or lung abscess (9 percent) were each considered. Opinions about the mortality asso­ciated with the nonsurgical management of massive hemoptysis also varied greatly. Of the approaches to airway support in […]