Antithrombin reduction after experimental cardiopulmonary resuscitation.
OBJECTIVE
To determine whether activation of coagulation and inflammation during cardiac arrest results in a reduction of antithrombin (AT) and an increase in thrombin-antithrombin (TAT) complex during reperfusion.


METHODS
Ventricular fibrillation (VF) was induced in ten anaesthetized pigs. After a 5-min non-intervention interval, closed-chest cardiopulmonary resuscitation (CPR) was performed for 9 min before defibrillation was attempted. If restoration of spontaneous circulation (ROSC) was achieved, the animals were observed for 4 h and repeated blood samples were taken for assay of AT, TAT and eicosanoids (8-iso-PGF(2alpha) and 15-keto-dihydro-PGF(2alpha)).


RESULTS
AT began to decrease 15 min after ROSC and the reduction continued throughout the observation period (P<0.05). The lowest mean value (79%) occurred 60 min after ROSC. The TAT level was increased during the first 3 h after ROSC (P<0.05), indicating thrombin generation. The eicosanoids were increased throughout the observation period (P<0.05).


CONCLUSIONS
AT is reduced and TAT and eicosanoids are increased after cardiac arrest, indicating activation of coagulation and inflammation.
Johansson
Jakob
J
Department of Surgical Sciences-Anesthesiology and Intensive Care, Uppsala University Hospital, S-751 85 Uppsala, Sweden. jakob.johansson@anestesi.uu.se
Ridefelt
Peter
P
Basu
Samar
S
Rubertsson
Sten
S
D000704:Analysis of Variance; D000818:Animals; D000991:Antithrombins / Q000032:analysis / Q000378:metabolism*; D015415:Biomarkers / Q000097:blood; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D015237:Dinoprost / Q000097:blood*; D004195:Disease Models, Animal; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D008297:Male; D015425:Myocardial Reperfusion; D011336:Probability; D011863:Radioimmunoassay; D011897:Random Allocation; D012680:Sensitivity and Specificity; D013552:Swine; D014693:Ventricular Fibrillation / Q000628:therapy*
D000991:Antithrombins; D015415:Biomarkers; D015237:Dinoprost