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STudy of Alteplase for Respiratory failure in SARS-Cov2 COVID-19 (STARS): A Vanguard Multicenter, Rapidly Adaptive, Pragmatic, Randomized, Controlled Trial
Chest. 2021 Sep 27:S0012-3692(21)04063-0. doi: 10.1016/j.chest.2021.09.024. Online ahead of print.ABSTRACTBACKGROUND: Pulmonary vascular microthrombi are a proposed mechanism of COVID19 respiratory failure. We hypothesized that early administration of tissue-plasminogen activator(tPA) followed by therapeutic heparin would improve pulmonary function in these patients.RESEARCH QUESTION: Does tPA improve pulmonary function in severe COVID-19 respiratory failure, and is it safe?STUDY DESIGN AND METHODS: Adults with COVID-19-induced respiratory failure were randomized May14,2020-March 3,2021 in two phases: Phase-1(n=36): contro...
Source: Chest - September 30, 2021 Category: Respiratory Medicine Authors: Christopher D Barrett Hunter B Moore Ernest E Moore D Janice Wang Negin Hajizadeh Walter L Biffl Lawrence Lottenberg Purvesh R Patel Michael S Truitt Robert McIntyre Todd M Bull Lee Anne Ammons Arsen Ghasabyan James Chandler Ivor Douglas Eric Schmidt Pete Source Type: research

Spontaneous Intraventricular Hemorrhage: When Should Intraventricular tPA Be Considered?
Semin Respir Crit Care Med 2017; 38: 745-759 DOI: 10.1055/s-0037-1607991Spontaneous intracerebral hemorrhage (ICH) is the most common cause of intraventricular hemorrhage (IVH) in adults. Complicating approximately 40% of ICH cases, IVH adds to the morbidity and mortality of this often fatal form of stroke. It is also a severity factor that complicates subarachnoid hemorrhage and traumatic brain injury, along with other less common causes of intracranial bleeding. Medical and surgical interventions to date have focused on limiting ICH and IVH expansion, controlling intracranial pressure, and relieving obstructive hydroceph...
Source: Seminars in Respiratory and Critical Care Medicine - December 20, 2017 Category: Respiratory Medicine Authors: Abdelmalik, Peter A. Ziai, Wendy C. Tags: Review Article Source Type: research