Evaluación tromboelastográfica de la coagulación durante maniobras de reanimación cardiopulmonar
Por:
Carrillo-Esper R., Díaz-Carrillo M.A., Pérez-Calatayud A.A., Zepeda-Mendoza A.D.
Publicada:
1 ene 2014
Categoría:
Internal Medicine
Resumen:
The effectiveness in cardiopulmonary resuscitation as proposed by the American Heart Association (AHA) Guidelines has increased the survival rate in patients with cardiac arrest, besides there is a rise in the presence of post-resuscitation disease with hematologic dysfunction requiring a dynamic monitoring. We report the case of a 71-year-old female patient with diabetes and systemic arterial hypertension with cardiac arrest. We initiated maneuvers recommended in the algorithms of de AHA and we obtained return to spontaneous circulation. During cardiopulmonary resuscitation maneuvers we obtained a thromboelastography curve which showed a hyperfibrinolytic pattern. In the initial phase of the postcardiac arrest syndrome we obtained again a thromboelastography curve, which presented a prothrombotic state. The severe coagulopathy that presents in postcardiac arrest syndrome, from a hyperfibrinolytic to a prothrombotic state, is the reason why we recommend the follow up and evaluation of coagulation using a thromboelastograph analyzer, which will help to have a better understanding of the therapeutic conduct in relation of thromboprophylaxis, anticoagulation and in special cases fibrinolytic therapy.
Filiaciones:
Carrillo-Esper R.:
Academia Nacional de Medicina, Academia Mexicana de Cirugía, Jefe de la Unidad de Terapia Intensiva, Mexico
Grupo Mexicano Para El Estudio de la Medicina Intensiva, Mexico
Díaz-Carrillo M.A.:
Residente de Medicina Intensiva, Fundación Clínica Médica Sur, Mexico
Grupo Mexicano Para El Estudio de la Medicina Intensiva, Mexico
Pérez-Calatayud A.A.:
Residente de Medicina Intensiva, Fundación Clínica Médica Sur, Mexico
Grupo Mexicano Para El Estudio de la Medicina Intensiva, Mexico
Zepeda-Mendoza A.D.:
Residente de Medicina Intensiva, Fundación Clínica Médica Sur, Mexico
Grupo Mexicano Para El Estudio de la Medicina Intensiva, Mexico
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