Anticoagulation therapy could improve the restoration of sinus rhythm and spontaneous circulation in hospital patients with CPR

Abstract

Objective To analyse the role of anticoagulation therapy in cardiopulmonary resuscitation (CPR) following an in-hospital cardiac arrest. Methods This single-centre retrospective cohort study enrolled patients treated with in-hospital CPR that met the inclusion and exclusion criteria. The patients were divided into a without anticoagulation group and an anticoagulation group. The main outcome measures were the restoration of spontaneous respiration, restoration of sinus rhythm (ROSR), restoration of spontaneous circulation (ROSC) and the hospital mortality. Results The study analysed 344 patients: 272 in the without anticoagulation group and 72 in the anticoagulation group. Multiple logistic regression analyses demonstrated that anticoagulation therapy improved ROSR (adjusted odds ratio [OR] 2.21, 95% confidence interval [CI] 1.23, 3.96) and ROSC (adjusted OR 1.91, 95% CI 1.08, 3.40), but it did not improve the restoration of spontaneous respiration (adjusted OR 1.64, 95% CI 0.72, 3.76) and hospital survival (adjusted OR 0.90, 95% CI 0.40, 1.99). Conclusion Anticoagulation therapy improved ROSR and ROSC, but did not decrease the mortality rate of hospitalized patients undergoing CPR following in-hospital cardiac arrest.

Mean arterial pressure is associated with the neurological function in patients who survived after cardiopulmonary resuscitation: A retrospective cohort study

“…the cerebral vascular autonomic regulation function would be lost due to ischemia and hypoxia of brain tissue after CPR 19 . (b) Cessation of blood flow during a cardiac arrest could result in microvascular thrombosis, 13 the formation of micro thrombosis would lead to an increase of vascular resistance and an increasing dependence of cerebral blood flow on the MAP.…”

“…The protocol of post-resuscitation care has been extensively described elsewhere, widely accepted, and applied. [12][13][14] All coma patients with cardiac arrest received targeted temperature management (TTM, target body temperature: 32 C-34 C for 24 hours, passive rewarming <0.5 C/ h). Midazolam, morphine, and cisatracurium were used for deep sedation to control shivering.…”