[Study on dynamic changes in coagulability and von Willebrand factor and its correlation with prognosis of cardiopulmonary resuscitation].
OBJECTIVE
To investigate dynamic changes in coagulability and von Willebrand factor (vWF), and explore their correlation with prognosis of cardiopulmonary resuscitation (CPR).


METHODS
Fifty CPR patients were divided into three groups according to the outcome. A group: 25 patients with successful recovery in the initial stage with restoration of spontaneous circulation (ROSC) lasting at least for 72 hours, but died ultimately; B group: 10 patients with successful recovery and finally survived; C group: the control group, 15 patients who died or ROSC<2 hours after CPR. In the course of CPR, dynamic changes in prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fg), platelet count (PLT), D-dimer, antithrombin III (AT III) and vWF were determined at the time of CPR, 24, 48 and 72 hours after ROSC.


RESULTS
During CPR, the levels of PT, APTT, TT, D-dimer and vWF were higher, and the levels of Fg, PLT and AT III were lower in group C compared with groups A and B (all P<0.01). There was no significant difference between groups A and B (all P>0.05). In groups A and B, the levels of PT, APTT, TT, D-dimer and vWF increased and the levels of Fg, PLT, AT III decreased 24 hours after ROSC. The changes in all parameters reached peak or valley point at ROSC 48 hours (P<0.05 or P<0.01). At ROSC 72 hours all parameters were improved more obviously in group B (all P<0.01), but not improved in group A (all P>0.05). The levels of PT, APTT, TT, D-dimer and vWF were much higher and the levels of Fg, PLT and AT III were much lower in group A than in group B (P<0.05 or P<0.01).


CONCLUSIONS
Tissue and vascular endothelial injury, endogenous and extrinsic coagulation disorder and fibrinolytic dysfunction are found in the patients undergoing CPR. Their dynamic changes are observed in the course of CPR, and they are valuable in assessing the severity of patients' condition and prognosis.
Zhou
Jing-xia
JX
Emergency Department of Chengde Central Hospital, Chengde 067000, Hebei, China. 2008zhoujx@163.com
Qi
Li-min
LM
Cheng
Rui-nian
RN
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult; D014841:von Willebrand Factor / Q000378:metabolism*
D014841:von Willebrand Factor