Characterizing the Coagulopathy Associated with Resuscitation Following Cardian Arrest

Abstract

It appears that a Post-Resuscitation Injury (PRI) contributes to the poor recovery in patients following cardiac arrest. One component of PRI may be a hypercoagulable condition. The purpose of this study was to determine if blood coagulability is increased in our laboratory model early in recovery following resuscitation from cardiac arrest. Adult Sprague Dawley rats were anesthetized and subjected to a cardiac arrest and resuscitation (A/R) protocol. During the study, arterial blood gases, heart rate, and blood pressure were monitored prior to cardiac arrest (PRE) and for two hours following resuscitation. Blood samples were taken at PRE, R60 and R120 to assess whole blood coagulability using thromboelastography (TEG). Twenty six A/R experiments were conducted. Five animals could not be resuscitated and two others did not survive the two hour recovery period. For the survivors, most (13/19) demonstrated a significant increase in coagulability (Coagulation Index, CI) during recovery. Surprisingly, the other survivors (6/19) demonstrated a hypocoagulable response during recovery in which marked intestinal hemorrhage, abdominal fluid accumulation, and hemodilution were often observed. It is believed that both the hypercoagulable and hypocoagulable responses may significantly complicate recovery in the early hours following successful resuscitation.