Document Detail


Effects of therapeutic hypothermia on coagulopathy and microcirculation after cardiopulmonary resuscitation in rabbits.
MedLine Citation:
PMID:  20951524     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to investigate the effects of therapeutic hypothermia (TH) on coagulopathy and cerebral microcirculation disorder after cardiopulmonary resuscitation (CPR) in rabbits.
METHODS: Cardiac ventricular fibrillation was induced by alternating current in 24 New Zealand rabbits, and hypothermia was induced by surface cooling or normothermia (NT) was maintained for 12 hours after the return of spontaneous circulation (ROSC). Several physiologic indexes were measured before CPR and at 4, 8, and 12 hours after ROSC. The microcirculation flow in the cerebral cortex was measured with a PERIMED Multichannel Laser Doppler system (Perimid, Sweden), and glomerular fibrin deposition was determined by microscopy.
RESULTS: Compared with the NT group, the prothrombin time, activated partial thromboplastin time, and international normalized ratio in the TH group were increased; there were no differences in anti-thrombin-III, protein C, and d-dimer indexes. The microcirculation flow in the cerebral cortex before CPR and after ROSC at 4, 8, and 12 hours was 401.60 ± 11.76, 258.86 ± 34.58, 317.59 ± 23.36, and 371.98 ± 5.79 mL/min, respectively, in the NT group, and 398.18 ± 12.91, 336.19 ± 19.27, 347.76 ± 13.80, and 383.78 ± 3.29 mL/min, respectively, in the TH group. There were apparent disparities at each checkpoint after ROSC in these 2 groups (4 hours: P = .001; 8 hours: P = .011; 12 hours: P = .009). The Pearson correlation test showed that the microcirculation flow in the cerebral cortex was positively correlated with activated partial thromboplastin time after ROSC (4 hours: r = 0.503, P = .033; 8 hours: r = 0.565, P = .035; 12 hours: r = 0.774, P = .009), but not with other coagulation parameters.
CONCLUSIONS: Therapeutic hypothermia might cause coagulant dysfunction but concomitantly improves the microcirculation flow in the cerebral cortex, which might be an effect of TH that results in cerebral protection.
Authors:
Hu Chun-Lin; Wen Jie; Liao Xiao-Xing; Li Xing; Li Yu-Jie; Zhan Hong; Jing Xiao-Li; Wu Gui-Fu
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Publication Detail:
Type:  Journal Article     Date:  2010-10-15
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  29     ISSN:  1532-8171     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1103-10     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510080, China.
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