Hemodynamic Effects of Bolus Infusion of Urokinase in Pulmonary Thromboembolism1–3

Hemodynamic changes were studied in 13 patients with acute pulmonary thromboembolism. Of 9 patients given bolus injections of urokinase into the pulmonary artery, 4 without prior history of cardiopulmonary disease showed a rapid and sustained decrease in pulmonary arterial pressure and total pulmonary resistance. In the 5 patients with a history of cardiovascular disease, changes in pulmonary arterial pressure and total pulmonary resistance were less dramatic. Angiographic improvement paralleled the decreases in pressure and resistance. Other hemodynamic alterations were minimal. Four similar patients treated with heparin alone failed to show an immediate decrease in pulmonary arterial pressure and total pulmonary resistance. Based upon the results obtained in this study, urokinase appears to be an effective agent in the therapy of acute pulmonary thromboembolism.