Journal article
Helicopter “Drip and Ship” Flights Do Not Alter the Pharmacological Integrity of rtPA
Journal of stroke and cerebrovascular diseases, Vol.27(10), pp.2720-2724
10/2018
DOI: 10.1016/j.jstrokecerebrovasdis.2018.05.049
PMCID: PMC6139266
PMID: 30037651
Abstract
Introduction
Rural and critical access hospitals rely on the “drip and ship” practice using helicopter emergency medical services (HEMS). But those helicopter flights are an unusual environment with physical factors such as vibration and accelerations that could potentially affect the stability, and pharmacological properties of IV rtPA, an issue that has not been previously addressed.
Materials and Methods
This was a prospective cohort study of consecutive acute ischemic stroke patients receiving IV rtPA through a Comprehensive Stroke Center from November 2015 to February 2017 to measure the effects of HEMS on the integrity and activity of rtPA by collecting residual medication left in the vial.
Clinical Trial Registration
http://www.clinicaltrials.gov
. NCT02752256
Results
A total of 33 patients and rtPA samples were included; 18 patients who presented directly to the Comprehensive Stroke Center emergency department and 15 patients who received rtPA during air ambulance transfer. The median rtPA antigen concentration in the residual medication vial was 3.04 mg/mL (IQR: 1.24-3.87) in the HEMS group and 1.91 mg/mL (IQR: 1.33-2.60) in the controls (P = .168). There were no significant differences in rtPA activity or specific activity between the HEMS and control groups and there was no association between total HEMS flight time on overall rtPA specific activity.
Conclusions
In summary, this study provides supportive evidence of the lack of a detrimental effect of the HEMS physical environment on the integrity of rtPA, therefore endorsing current drip and ship practices without infusion adjustments.
Details
- Title: Subtitle
- Helicopter “Drip and Ship” Flights Do Not Alter the Pharmacological Integrity of rtPA
- Creators
- Brett A Faine - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaSanjana Dayal - Department of Molecular Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaRahul Kumar - Department of Molecular Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaSteven R Lentz - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaEnrique C Leira - Departments of Neurology and Neurosurgery, Carver College of Medicine, and Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of stroke and cerebrovascular diseases, Vol.27(10), pp.2720-2724
- DOI
- 10.1016/j.jstrokecerebrovasdis.2018.05.049
- PMID
- 30037651
- PMCID
- PMC6139266
- NLM abbreviation
- J Stroke Cerebrovasc Dis
- ISSN
- 1052-3057
- eISSN
- 1532-8511
- Publisher
- Elsevier Inc
- Grant note
- U10MS086521-01 / NINDS (http://dx.doi.org/10.13039/100000065) 13SDG14050002 / American Heart Association (http://dx.doi.org/10.13039/100000968) RO1AG049784 / National Institutes of Health (http://dx.doi.org/10.13039/100000002)
- Language
- English
- Date published
- 10/2018
- Academic Unit
- Neurology; Hematology, Oncology, and Blood & Marrow Transplantation; Epidemiology; Emergency Medicine; Iowa Neuroscience Institute; Pharmacy Practice and Science; Fraternal Order of Eagles Diabetes Research Center; Neurosurgery; Internal Medicine
- Record Identifier
- 9984070459102771
Metrics
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