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. (C) 2003 Elsevier Ireland Ltd. All rights reserved.