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| Effect of mild hypothermia therapy on coagulation function of by monitoring thromboelastography in patients with cardiopulmonary resuscitation |
| Gao Fei, Yan Jie |
| Department of Intensive Care Unit,Wuxi People’s Hospital Affiliated to Nanjing Medical University, Wuxi 214023, China |
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Abstract Objective To investigate the effect of mild hypothermia on blood coagulation function in patients with cardiopulmonary resuscitation and the value of thromboelastography（TEG）monitoring. Methods We prospectively selected 50 cases of cardiopulmonary resuscitation in ICU and EICU from June 2013 to December 2015. Venous blood samples were collected when their temperature was 37 ℃ and 33 ℃. The blood samples were used to detect coagulation function（PT, APTT and Fib, PLT）and TEG. We compared the two methods by analyzing the correlation of each index. We also analyzed the coagulation reaction time（R）, clot formation time（K）, rate of clot formation（Angle）, maximum ampli⁃ tude（MA）and coagulation index（CI）with temperature changes. According to the temperature of 37 ℃CI, they were divided into normal and abnormal coagulation function; then we analyzed the differences of TEG index between the two groups that affected by temperature. Results ①R and PT, APTT were positively correlated（r = 0.435, 0.461, P＜0.05）; K and Fib, PLT was negatively correlated（r = - 0.426, -0.358, P＜0.05）, angle and Fib; PLT were positively correlated（R, 0.374, P＜0.05）; MA and Fib, PLT were positively correlated（r = 0.449, 0.560, P＜0.05）. ②Fifity cases of cardiopulmonary re⁃ suscitation patients with the decrease of temperature, R, K, TEG values showed a tendency to extend; An⁃ gle, MA, CI showed a decreasing trend. ③TEG temperature from 37 ℃ to 33 ℃, all the differences be⁃ tween the indicators were statistically significant（P＜0.05）. ④In normal blood coagulation function and abnormal groups under 37 ℃, as the temperature declined, R, K value was prolonged, and Angle, MA and CI values were decreased; but the values were more pronounced in abnormal group than those in the normal group significantly（P＜0.05）. Conclusion Low temperature has great influence on the func⁃ tion of blood coagulation in patients with cardiopulmonary resuscitation. Determination of TEG is not re⁃ stricted by the change of the temperature. It more accurately reflects the actual patient body temperature of coagulation function, and helps to provide guidance for clinical application of individual mild hypo⁃ thermia treatment.
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Received: 19 April 2016
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Corresponding Authors:
Yan Jie, E-mail: yjeast@163.com
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