ArticleResuscitation plus2026
Intra-arrest systemic thrombolytic therapy during cardiopulmonary resuscitation: a systematic review and meta-analysis of randomized controlled trials.
Article in Resuscitation plus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Reply to: Rethinking intra-arrest thrombolysis: the role of patient selection and timing.Resuscitation plus · 2026Article
- Rethinking intra-arrest thrombolysis: the role of patient selection and timing.Resuscitation plus · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Systemic thrombolysis has been proposed as a routine treatment for cardiac arrest, given potential benefits in treating fibrin formation and/or in treating the etiology of the cardiac arrest (e.g. ST-elevation myocardial infarction and pulmonary embolism [PE]). This systematic review and meta-analysis aimed to evaluate the effect of intra-arrest thrombolysis on survival and neurological outcomes in patients with cardiac arrest. Methods: We searched MEDLINE, EMBASE, CENTRAL, and the Web of Science from inception until September 30, 2025 for randomized controlled trials evaluating systemic thrombolytic therapy versus standard care during cardiopulmonary resuscitation (CPR). The primary outcome was survival to hospital discharge, and the secondary outcomes were favorable neurological outcome at hospital discharge, return of spontaneous circulation (ROSC), and survival to hospital admission. We performed meta-analyses using a random-effects model. We evaluated bleeding complications and examined Utstein-based subgroups. We evaluated risk of bias using the Cochrane Risk of Bias 2 tool and evidence certainty using GRADE. Results: We included three RCTs, which enrolled a total of 1318 participants. Thrombolysis did not improve survival (RR 0.86; 95% CI 0.65-1.14) or favorable neurological outcome (RR 0.99; 95% CI 0.69-1.40) at hospital discharge. No benefit was observed for ROSC or survival to admission. Thrombolysis increased the risk of any intracranial hemorrhage (RR 6.96, 95% CI 1.59-30.47). Among cases with bystander CPR, thrombolysis led to decreased survival; other subgroup analyses were neutral. Conclusions: Available evidence demonstrates that routine intra-arrest thrombolysis in unselected patients does not improve hospital-discharge survival, however does increase bleeding risk.
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Registered trials
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