The prognostic value of coagulofibrinolytic changes in survivors of adult extracorporeal cardiopulmonary resuscitation
10.3760/cma.j.issn.1671-0282.2024.07.009
- VernacularTitle:凝血/纤溶改变对成人体外心肺复苏患者神经功能预后的预测价值研究
- Author:
Gannan WANG
1
;
Gang ZHANG
;
Zhongman ZHANG
;
Wei LI
;
Yong MEI
;
Xufeng CHEN
Author Information
1. 南京医科大学第一附属医院急诊医学中心，南京 210029
- Keywords:
Cardiopulmonary resuscitation;
Extracorporeal membrane oxygenation;
Coagulation dysfunction;
Prognosis
- From:
Chinese Journal of Emergency Medicine
2024;33(7):933-938
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the prognostic value of coagulofibrinolytic changes in survivors of adult extracorporeal cardiopulmonary resuscitation (ECPR) in Chinese.Methods:133 cardiac arrest (CA) patients whose blood samples were collected after establishment of extracorporeal membrane oxygenation between January 2018 and April 2023 in Emergency Department of the First Affiliated Hospital of Nangjing Medical University were enrolled in this single-center study. The following were examined: platelet counts (PLT), prothrombin time (PT), activated partial thrombin time (APTT), thrombin time (TT), fibrinogen (Fib), and D-dimer (D-D). The prognostic values of these coagulation-related indicators in predicting poor outcomes (Cerebral Performance Category 3-5) were analyzed.Results:Among the 133 patients involved, 96 (72.2%) had poor outcomes after ECPR treatment. In the poor-outcome group, PLT and Fib were significantly decreased, while PT and APTT were significantly prolonged (all P < 0.05). ECPR survivors had a significantly higher risk of poor neurological outcomes in the high-level group than those in the low-level group for PT ( HR=1.87, 95% CI:1.17-2.99, P=0.009), APTT ( HR=1.95, 95% CI:1.26-3.00, P=0.003), and D-D levels ( HR=5.18, 95% CI:2.06-13.03, P<0.001). The risk of poor neurological outcomes was significantly lower in the high-level group for PLT ( HR=0.55, 95%CI:0.35-0.84, P=0.007). Conclusion:Coagulofibrinolytic changes can be promising tools to assess poor neurological outcomes in adult ECPR survivors.
