Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2023 Jan 6;18(1):e0279653.
doi: 10.1371/journal.pone.0279653. eCollection 2023.

Coagulation measures after cardiac arrest (CMACA)

Hyo Joon Kim  1 , Kurz Michael  2 , Jung Hee Wee  3 , Joo Suk Oh  4 , Won Young Kim  5 , In Soo Cho  6 , Mi Jin Lee  7 , Dong Hun Lee  8 , Yong Hwan Kim  9 , Chun Song Youn  1
Affiliations
Observational Study

Coagulation measures after cardiac arrest (CMACA)

Hyo Joon Kim et al. PLoS One. .

Abstract

Background: During cardiac arrest (CA) and after cardiopulmonary resuscitation, activation of blood coagulation and inadequate endogenous fibrinolysis occur. The aim of this study was to describe the time course of coagulation abnormalities after out-of-hospital CA (OHCA) and to examine the association with clinical outcomes in patients undergoing targeted temperature management (TTM) after OHCA.

Methods: This prospective, multicenter, observational cohort study was performed in eight emergency departments in Korea between September 2018 and September 2019. Laboratory findings from hospital admission and 24 hours after return of spontaneous circulation (ROSC) were analyzed. The primary outcome was cerebral performance category (CPC) at discharge, and the secondary outcome was in-hospital mortality.

Results: A total of 170 patients were included in this study. The lactic acid, prothrombin time (PT), activated partial thrombin time (aPTT), international normalized ratio (INR), and D-dimer levels were higher in patients with poor neurological outcomes at admission and 24 h after ROSC. The lactic acid and D-dimer levels decreased over time, while fibrinogen increased over time. PT, aPTT, and INR did not change over time. The PT at admission and D-dimer levels 24 h after ROSC were associated with neurological outcomes at hospital discharge. Coagulation-related factors were moderately correlated with the duration of time from collapse to ROSC.

Conclusion: The time-dependent changes in coagulation-related factors are diverse. Among coagulation-related factors, PT at admission and D-dimer levels 24 h after ROSC were associated with poor neurological outcomes at hospital discharge in patients treated with TTM.

PubMed Disclaimer

Conflict of interest statement

None of the authors has declared a conflict of interest.

Figures

Fig 1
Fig 1. Coagulation-related factors and outcome groups of the study patients.
The medians with interquartile ranges (box) and 10th-90th percentiles (whiskers) are presented. A represents coagulation-related factors between admission and 24 hours after ROSC. B represents coagulation-related factors according to neurological outcomes between admission and 24 hours after ROSC. (Differences between the groups are statistically significant at the p<0.05 level).
See this image and copyright information in PMC

References

    1. Kiguchi T, Okubo M, Nishiyama C, Maconochie I, Ong MEH, Kern KB, et al.. Out-of-hospital cardiac arrest across the World: First report from the International Liaison Committee on Resuscitation (ILCOR). Resuscitation. 2020;152:39–49. doi: 10.1016/j.resuscitation.2020.02.044 - DOI - PubMed
    1. Gräsner J-T, Lefering R, Koster RW, Masterson S, Böttiger BW, Herlitz J, et al.. EuReCa ONE⿿27 Nations, ONE Europe, ONE Registry. Resuscitation. 2016;105:188–95. doi: 10.1016/j.resuscitation.2016.06.004 - DOI - PubMed
    1. Adrie C, Adib-Conquy M, Laurent I, Monchi M, Vinsonneau C, Fitting C, et al.. Successful cardiopulmonary resuscitation after cardiac arrest as a "sepsis-Like" syndrome. Circulation. 2002;106(5):562–8. doi: 10.1161/01.cir.0000023891.80661.ad WOS:000177323700016. - DOI - PubMed
    1. Salluh JIF, Rabello LSCF, Rosolem MM, Soares M, Bozza FA, Verdeal JCR, et al..: The impact of coagulation parameters on the outcomes of patients with severe community-acquired pneumonia requiring intensive care unit admission. Journal of Critical Care 2011, 26(5):496–501. doi: 10.1016/j.jcrc.2011.02.001 - DOI - PubMed
    1. Morton AP, Moore EE, Wohlauer MV, Lo K, Silliman CC, Burlew CC, et al..: Revisiting early postinjury mortality: Are they bleeding because they are dying or dying because they are bleeding? Journal of Surgical Research 2013, 179(1):5–9. doi: 10.1016/j.jss.2012.05.054 - DOI - PMC - PubMed

Publication types