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Tissue plasminogen activator (tPA) in acute ischaemic stroke: time for collegiate communication and consensus
Ist Teil von
Medical journal of Australia, 2004-06, Vol.180 (12), p.634-636
Ort / Verlag
Sydney: Australasian Medical Publishing Company
Erscheinungsjahr
2004
Quelle
MEDLINE
Beschreibungen/Notizen
Systematic reviews of randomised trials of tPA in acute ischaemic stroke indicate a clear benefit of treating selected patients within 3 hours of stroke onset. Moreover, a net benefit remained after adjustment for chance baseline imbalances between subgroups in stroke severity within one of these trials (National Institute of Neurological Disorders and Stroke [NINDS]).
Rates of favourable outcomes and intracranial haemorrhage comparable with those in randomised trials can be achieved in routine clinical practice; however, translation of net benefit from tPA therapy requires organised and coordinated stroke management across the continuum of care.
Prerequisites for well organised and coordinated acute stroke care are:
➢consensus among care providers on the use of tPA;
➢stroke‐care teams spanning the gaps between pre‐hospital care, emergency departments and stroke units; and
➢collegiate relations and effective communication networks between care providers.