Coagulation Measures After Cardiac Arrest (CMACA)

Hyo Joon Kim, Kurz Michael, Jung Hee Wee, Joo Suk Oh, Won Young Kim, In Soo Cho, Mi Jin Lee, Dong Hun Lee, Yong Hwan Kim, Chun Song Youn

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.

Despite advances in critical care, including targeted temperature management (TTM), out-of-hospital cardiac arrest (OHCA) still has high mortality and morbidity rates. Systemic inflammation and increased coagulation due to whole-body ischemia and reperfusion after cardiac arrest (CA) play an important role in hypoxic brain injury and multiple organ dysfunction.


Study design and setting
This prospective, multicenter, observational cohort study was performed in eight emergency departments of university-affiliated teaching hospitals in Korea between September 2018 and September 2019. Adult (over 19 years of age) comatose OHCA patients with ROSC treated with TTM irrespective of their initial rhythm and etiology of CA were enrolled.

Blood sample assays
Blood samples were collected two times using existing intravenous access. The first blood sample was collected within 60 minutes after ROSC, and the second was collected 24 hours after ROSC

The main findings of this prospective, multicenter, observational cohort study regarding OHCA patients treated with TTM are as follows: first, lactic acid, PT, aPTT, INR, and D-dimer levels were higher in patients with poor neurological outcomes at admission and 24 h after ROSC. Second, lactic acid and D-dimer levels decreased over time, while fibrinogen increased over time. PT, aPTT, and INR did not change over time.

Citation: Kim HJ, Michael K, Wee JH, Oh JS, Kim WY, Cho IS, et al. (2023) Coagulation measures after cardiac arrest (CMACA). PLoS ONE 18(1): e0279653.

Editor: Chiara Lazzeri, Azienda Ospedaliero Universitaria Careggi, ITALY

Received: May 8, 2022; Accepted: December 4, 2022; Published: January 6, 2023.

Copyright: © 2023 Kim et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the paper and its Supporting Information file.

Funding: This research was supported by ZOLL Foundation. There was no additional external funding received for this study.

Competing interests: None of the authors has declared a conflict of interest.