Evidence map›Paper›PMID 28695976›Full record

ArticleCardiology journal2019

Adaptation of global hemostasis to therapeutic hypothermia in patients with out-of-hospital cardiac arrest: Thromboelastography study.

Aleksander Trąbka-Zawicki, Marek Tomala, Aleksander Zeliaś, Elżbieta Paszek, Wojciech Zajdel, Ewa Stępień, Krzysztof Żmudka

Open access · goldAbstract read
In one paragraph

Article in Cardiology journal, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Aleksander Trąbka-ZawickiDepartment of Interventional Cardiology, Jagiellonian University, John Paul II Hospital, Krakow, Poland. atz84@o2.pl.
Marek TomalaDepartment of Interventional Cardiology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Aleksander ZeliaśDepartment of Interventional Cardiology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Elżbieta PaszekDepartment of Interventional Cardiology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Wojciech ZajdelDepartment of Interventional Cardiology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
Ewa StępieńDepartment of Medical Physics, Marian Smoluchowski Institute of Physiscs, Faculty of Physics, Astronomy, and Applied Computer, Jagiellonian University, Krakow, Poland.
Krzysztof ŻmudkaDepartment of Interventional Cardiology, Jagiellonian University, John Paul II Hospital, Krakow, Poland.
John Paul II Hospital · PLJagiellonian University · PL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of mild therapeutic hypothermia (MTH) in patients after out-of-hospital cardiac arrest (OHCA) who are undergoing primary percutaneous coronary intervention (pPCI) can protect patients from thromboembolic complications. The aim of the study was to evaluate the adaptive mecha- nisms of the coagulation system in MTH-treated comatose OHCA survivors.

methodsTwenty one comatose OHCA survivors with acute coronary syndrome undergoing imme- diate pPCI were treated with MTH. Quantitative and qualitative analyses of physical clot properties were performed using thromboelastography (TEG). Two analysis time points were proposed: 1) during MTH with in vitro rewarming conditions (37°C) and 2) after restoration of normothermia (NT) under normal (37°C) and in vitro cooling conditions (32°C).

resultsDuring MTH compared to NT, reaction time (R) was lengthened, clot kinetic parameter (a) was significantly reduced, but no effect on clot strength (MA) was observed. Finally, the coagulation index (CI) was significantly reduced with clot fibrinolysis attenuated during MTH. The clot lysis time (CLT) was shortened, and clot stability (LY60) was lower compared with those values during NT. In vitro cooling generally influenced clot kinetics and reduced clot stability after treatment.

conclusionsThromboelastography is a useful method for evaluation of coagulation system dysfunc- tion in OHCA survivors undergoing MTH. Coagulation impairment in hypothermia was associated with a reduced rate of clot formation, increased weakness of clot strength, and disturbances of fibrinoly- sis. Blood sample analyses performed at 32°C during MTH, instead of the standard 37°C, seems to enhance the accuracy of the evaluation of coagulation impairment in hypothermia.

Indexed as

Adaptation, PhysiologicalAgedBlood CoagulationFemaleFollow-Up StudiesHemodynamicsHemostasisHumansHypothermia, InducedMaleOut-of-Hospital Cardiac ArrestProspective StudiesThrombelastographycardiac arrestcoagulationhypothermiathromboelastography

Identifiers

PMID28695976
PMCPMC8086693
OpenAlexW2736166028

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.