Hemodynamic changes and safety of different doses of reteplase in thrombolysis treatment of acute massive pulmonary embolism

AIM:To evaluate the hemodynamic changes and safety of reteplase in the treatment of acute massive pulmonary embolism. METHODS: Thirty-nine patients with severe pulmonary embolism selected for thrombolytic therapy were divided into two groups: 24 patients receiving intravenous reteplase (18 mg once) (single dose group) and 15 patients receiving intravenous reteplase 18 mg twice, with a 30-min interval (double dose group). All patients were monitored for 24 h after treatment and hemodynamic indexes including total pulmonary resistance, pulmonary artery pressure, cardiac index, with vital sign changes and adverse events were recorded and compared between groups. RESULTS: The total pulmonary resistance in both groups decreased after treatment and pulmonary artery pressure and cardiac index were improved, with no significant difference between groups. Incidence of adverse events in the single dose group was significantly lower than that in the double dose group (P<0.05). CONCLUSION: Reteplase can be used for treatment of acute massive pulmonary embolism. Although there is no therapeutic difference between single dose treatment and double dose treatment, single dose treatment is safer.