Usefulness of serum fibrin degradation products and D-dimer levels as biomarkers to predict return of spontaneous circulation in patients with cardiopulmonary arrest on arrival: comparison with acid-base balance
Usefulness of serum fibrin degradation products and D-dimer levels as biomarkers to predict return of spontaneous circulation in patients with cardiopulmonary arrest on arrival: comparison with acid-base balance
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DOI：
10.1002/ams2.44
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发表时间：
2014-10-01
影响因子：
1.6
通讯作者：
Oshima, Kiyohiro
中科院分区：
文献类型：
--
作者：
Hagiwara, Shuichi;Murata, Masato;Oshima, Kiyohiro
目的：与阴离子间隙和白蛋白校正阴离子间隙相比，评估血液中纤维蛋白降解产物和D-二聚体水平对预测心肺骤停患者自主循环恢复的有用性。方法：回顾性回顾2012年转入我院急诊科的心肺骤停患者的病历。将患者分为两组：自主循环恢复患者（ROSC（+）组）和未恢复自主循环患者。 （ROSC（-）组）。比较两组到达时测量的阴离子间隙、白蛋白校正阴离子间隙、纤维蛋白降解产物和D-二聚体的水平。结果：可分析53名患者。 ROSC(+) 组的阴离子间隙和白蛋白校正阴离子间隙水平显着优于 ROSC(-) 组（阴离子间隙，28.7 mmol/L [中位数] vs 39.1 mmol/L；白蛋白校正阴离子间隙，31.1 mmol/L vs 40.9 mmol/L）。 ROSC(+)组的纤维蛋白降解产物和D-二聚体水平显着低于ROSC(-)组(纤维蛋白降解产物，32.1μg/mL vs 157.4μg/mL；D-二聚体，9.9μg/mL vs 37.4μg/mL)。用于评估阴离子间隙、白蛋白校正阴离子间隙、纤维蛋白降解产物和 D-二聚体与自主循环恢复关系的受试者工作特征曲线下面积分别为 0.664、0.667、0.714 和 0.707。 结论：纤维蛋白降解产物和 D-二聚体水平可能比阴离子间隙和白蛋白校正阴离子间隙更能作为自发循环恢复的预测因子。
Aim: We evaluated the usefulness of fibrin degradation products and D-dimer levels in blood to predict return of spontaneous circulation in patients with cardiopulmonary arrest on arrival compared with anion gap and albumin-corrected anion gap.Methods: We retrospectively reviewed the medical records of patients with cardiopulmonary arrest on arrival who had been transferred to the emergency department of our hospital in 2012. Patients were divided into two groups: patients with return of spontaneous circulation (ROSC(+) group), and those without (ROSC(-) group). The levels of anion gap, albumin-corrected anion gap, fibrin degradation products and D-dimer measured on arrival were compared between the two groups.Results: Fifty-three patients could be analyzed. The anion gap and albumin-corrected anion gap levels were significantly better in the ROSC(+) group than in the ROSC(-) group (anion gap, 28.7 mmol/L [median] versus 39.1 mmol/L; albumin-corrected anion gap, 31.1 mmol/L versus 40.9 mmol/L). The fibrin degradation product and D-dimer levels were significantly lower in the ROSC(+) group than in the ROSC(-) group (fibrin degradation products, 32.1 mu g/mL versus 157.4 mu g/mL; D-dimer, 9.9 mu g/mL versus 37.4 mu g/mL). The area under receiver operating characteristic curves to evaluate the relationship with return of spontaneous circulation of anion gap, albumincorrected anion gap, fibrin degradation products, and D-dimer were 0.664, 0.667, 0.714, and 0.707, respectively.Conclusion: Fibrin degradation products and D-dimer levels might be more useful as predictors of return of spontaneous circulation than anion gap and albumin-corrected anion gap.