Prolonged targeted temperature management compromises thrombin generation: A randomised clinical trial

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Standard

Prolonged targeted temperature management compromises thrombin generation : A randomised clinical trial. / Jeppesen, Anni Nørgaard; Hvas, Anne-Mette; Duez, Christophe Henri Valdemar; Grejs, Anders Morten; Ilkjær, Susanne; Kirkegaard, Hans.

I: Resuscitation, Bind 118, 11.2017.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Harvard

APA

CBE

MLA

Vancouver

Author

Bibtex

@article{c5c50c1522904e68ad6adb95c49b2178,
title = "Prolonged targeted temperature management compromises thrombin generation: A randomised clinical trial",
abstract = "AIM: To investigate whether prolonged compared with standard duration of targeted temperature management (TTM) compromises coagulation.METHODS: Comatose survivors after out-of-hospital cardiac arrest (n=82) were randomised to standard (24h) or prolonged (48h) duration of TTM at 33±1°C. Blood samples were drawn 22, 46 and 70h after attaining the target temperature. Samples were analysed for rotational thromboelastometry (ROTEM({\circledR}) (EXTEM({\circledR}), INTEM({\circledR}), FIBTEM({\circledR}) and HEPTEM({\circledR}))) and thrombin generation using the Calibrated Automated Thrombogram({\circledR}) assay.RESULTS: With the 22-h sample, we revealed no difference between groups in the ROTEM({\circledR}) and thrombin generation results beside a slightly higher EXTEM({\circledR}) and INTEM({\circledR}) maximum velocity in the prolonged group (p-values≤0.04). With the 46-h sample, ROTEM({\circledR}) showed no differences when using EXTEM({\circledR}); however, 11{\%} (p<0.01) longer clotting time and 12{\%} (p<0.01) longer time to maximum velocity were evident in the prolonged group than in the standard group when using INTEM({\circledR}). The prolonged group had reduced thrombin generation compared with the standard group as indicated by 30{\%} longer lag time (p=0.04), 106nM decreased peak concentration (p<0.001), 36{\%} longer time to peak (p=0.01) and 411 nM*minute decreased endogenous thrombin potential (p<0.001). With the 70-h sample, no differences in ROTEM({\circledR}) results were found between groups. However, the prolonged group had reduced thrombin generation indicated by longer lag time, decreased peak concentration and longer time to peak (all p-values≤0.02) compared with the standard group.CONCLUSION: Prolonged TTM in post-cardiac arrest patients impairs thrombin generation. ClinicalTrials.gov identifier: NCT02258360.",
keywords = "Journal Article",
author = "Jeppesen, {Anni N{\o}rgaard} and Anne-Mette Hvas and Duez, {Christophe Henri Valdemar} and Grejs, {Anders Morten} and Susanne Ilkj{\ae}r and Hans Kirkegaard",
note = "Copyright {\circledC} 2017 Elsevier B.V. All rights reserved.",
year = "2017",
month = "11",
doi = "10.1016/j.resuscitation.2017.06.004",
language = "English",
volume = "118",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd.",

}

RIS

TY - JOUR

T1 - Prolonged targeted temperature management compromises thrombin generation

T2 - A randomised clinical trial

AU - Jeppesen, Anni Nørgaard

AU - Hvas, Anne-Mette

AU - Duez, Christophe Henri Valdemar

AU - Grejs, Anders Morten

AU - Ilkjær, Susanne

AU - Kirkegaard, Hans

N1 - Copyright © 2017 Elsevier B.V. All rights reserved.

PY - 2017/11

Y1 - 2017/11

N2 - AIM: To investigate whether prolonged compared with standard duration of targeted temperature management (TTM) compromises coagulation.METHODS: Comatose survivors after out-of-hospital cardiac arrest (n=82) were randomised to standard (24h) or prolonged (48h) duration of TTM at 33±1°C. Blood samples were drawn 22, 46 and 70h after attaining the target temperature. Samples were analysed for rotational thromboelastometry (ROTEM(®) (EXTEM(®), INTEM(®), FIBTEM(®) and HEPTEM(®))) and thrombin generation using the Calibrated Automated Thrombogram(®) assay.RESULTS: With the 22-h sample, we revealed no difference between groups in the ROTEM(®) and thrombin generation results beside a slightly higher EXTEM(®) and INTEM(®) maximum velocity in the prolonged group (p-values≤0.04). With the 46-h sample, ROTEM(®) showed no differences when using EXTEM(®); however, 11% (p<0.01) longer clotting time and 12% (p<0.01) longer time to maximum velocity were evident in the prolonged group than in the standard group when using INTEM(®). The prolonged group had reduced thrombin generation compared with the standard group as indicated by 30% longer lag time (p=0.04), 106nM decreased peak concentration (p<0.001), 36% longer time to peak (p=0.01) and 411 nM*minute decreased endogenous thrombin potential (p<0.001). With the 70-h sample, no differences in ROTEM(®) results were found between groups. However, the prolonged group had reduced thrombin generation indicated by longer lag time, decreased peak concentration and longer time to peak (all p-values≤0.02) compared with the standard group.CONCLUSION: Prolonged TTM in post-cardiac arrest patients impairs thrombin generation. ClinicalTrials.gov identifier: NCT02258360.

AB - AIM: To investigate whether prolonged compared with standard duration of targeted temperature management (TTM) compromises coagulation.METHODS: Comatose survivors after out-of-hospital cardiac arrest (n=82) were randomised to standard (24h) or prolonged (48h) duration of TTM at 33±1°C. Blood samples were drawn 22, 46 and 70h after attaining the target temperature. Samples were analysed for rotational thromboelastometry (ROTEM(®) (EXTEM(®), INTEM(®), FIBTEM(®) and HEPTEM(®))) and thrombin generation using the Calibrated Automated Thrombogram(®) assay.RESULTS: With the 22-h sample, we revealed no difference between groups in the ROTEM(®) and thrombin generation results beside a slightly higher EXTEM(®) and INTEM(®) maximum velocity in the prolonged group (p-values≤0.04). With the 46-h sample, ROTEM(®) showed no differences when using EXTEM(®); however, 11% (p<0.01) longer clotting time and 12% (p<0.01) longer time to maximum velocity were evident in the prolonged group than in the standard group when using INTEM(®). The prolonged group had reduced thrombin generation compared with the standard group as indicated by 30% longer lag time (p=0.04), 106nM decreased peak concentration (p<0.001), 36% longer time to peak (p=0.01) and 411 nM*minute decreased endogenous thrombin potential (p<0.001). With the 70-h sample, no differences in ROTEM(®) results were found between groups. However, the prolonged group had reduced thrombin generation indicated by longer lag time, decreased peak concentration and longer time to peak (all p-values≤0.02) compared with the standard group.CONCLUSION: Prolonged TTM in post-cardiac arrest patients impairs thrombin generation. ClinicalTrials.gov identifier: NCT02258360.

KW - Journal Article

U2 - 10.1016/j.resuscitation.2017.06.004

DO - 10.1016/j.resuscitation.2017.06.004

M3 - Journal article

C2 - 28602694

VL - 118

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -