Investigation of Thrombolysis with Reteplase on Vital Signs, Right Ventricular Parameters and Clinical Symptoms of Patients with Acute Massive and Sub-massive Pulmonary Embolism

Abstract

Background: This study aimed to evaluate the effectiveness of thrombolysis with reteplase in patients with acute pulmonary embolism (PE) requiring thrombolytic treatment in the cardiac wards of Valiasr and Razi hospitals in Birjand, Iran. The study was conducted over a five-year period. Methods: The study included patients with acute massive and sub-massive PE who received thrombolysis with reteplase from early 2016 to late 2020. Additionally, a one-year follow-up was conducted to monitor any complications. Results: A total of 28 patients participated in this study, with an average age of 54 ± 12 years. Findings showed that hypotension, chest pain, and hemoptysis resolved within 48 hours after reteplase administration. Reteplase also had a significant impact on improving hypoxemia (SPO2) and stabilizing vital signs, including heart rate (HR), respiratory rate (RR), and blood pressure (BP), as well as enhancing right ventricular (RV) function and reducing pulmonary artery pressure. The majority of patients (55%) had no deep vein involvement, and most did not report complications after discharge. Conclusions: This study observed that reteplase was highly effective, leading to rapid clinical improvement without an increased risk of significant bleeding or mortality. Although limited by its retrospective nature, the study suggests that reteplase is a viable treatment option for PE.