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is the clinical situation that best represents global ischemia&#8211;reperfusion&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">7</span></a> Several studies have recently described the incidence of hyperfibrinolysis in these patients by using viscoelastic testing&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">8&#44;9</span></a> The implementation of viscoelastic testing &#40;Tem Innovations GmbH&#44; Munich&#44; Germany&#41; in the clinical practice has allowed us to go deeper in what we know about clotting disorders&#46; We believe that the use of viscoelastic testing can improve our understanding of the underlying mechanisms that correlate clotting and hypoperfusion&#46; Therefore&#44; the goal of this study is to describe clotting alterations using traditional and viscoelastic laboratory modalities &#40;ROTEM&#41; in a cohort of potential donors in uncontrolled asystole &#40;Maastricht type IIa&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Design and methods</span><p id="par0010" class="elsevierStylePara elsevierViewall">Prospective&#44; observational study conducted at Hospital Universitario 12 de Octubre from January 2015 to January 2016&#46; Our hospital ethics committee approved the study &#40;12&#47;160&#41;&#46; All the patients from our center considered eligible to enter the program of uncontrolled asystole donation &#40;Maastricht type IIa&#41; were included in this study&#46; The procedure of this donation program is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The initial out-of-hospital care was provided by our team of specialists in special care&#46; This out-of-hospital care team examined those patients who may be potential donors based on the aforementioned criteria&#46; After confirming the criteria&#44; the hospital service was activated as asystole code and the team proceeded with the transfer&#46; The hospital acceptance of the potential donor was conducted by the Intensive Medicine unit&#46; Upon the patient&#39;s arrival&#44; the team confirmed his death&#44; the selection criteria&#44; and the decision to move ahead or terminate the entire process of donation&#46; After making the decision&#44; blood samples were collected for this study&#46; The blood samples were collected after the insertion of one IV cannula and after discarding 2<span class="elsevierStyleHsp" style=""></span>mL of blood&#46; No drugs were administered during hospital care before collecting the blood samples&#46; For conventional clotting study and viscoelastic modality purposes&#44; tubes with citrate &#40;3&#46;2&#37; sodium citrate&#41; were used&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The out-of-hospital service report included demographic variables &#40;age and sex&#41;&#44; clinical variables &#40;initial heart rhythm&#41; and CRA-related time variables&#58; &#40;a&#41; time elapsed since the cardiac arrest until starting life support&#59; &#40;b&#41; time elapsed since the cardiac arrest until starting advanced life support&#44; and &#40;c&#41; time elapsed since the cardiac arrest until proceeding to collect the blood samples &#40;cardiac arrest time&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In order to determine the aforementioned parameters&#44; the ROTEM Delta<span class="elsevierStyleSup">&#174;</span> system was used &#40;Tem Innovations GmbH&#44; Munich&#44; Germany&#41;&#46; The reference values already published in the medical literature were used&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">10</span></a> The ROTEM analysis was conducted within the 30<span class="elsevierStyleHsp" style=""></span>min that followed the collection of every blood sample&#46; The EXTEM &#40;ex-tem<span class="elsevierStyleSup">&#174;</span> recombinant reactive tissue factor activation&#41;&#44; APTEM &#40;same activation as EXTEM&#44; fibrinolytic activation with aprotinin&#41; and FIBTEM &#40;same activation as EXTEM&#44; platelet activation with cytochalasin D&#41; tests were run on all the blood samples collected&#46; The following variables were recorded&#58; clotting time &#40;CT&#44; seconds&#41;&#59; time elapsed since the initial measurement to the formation of a 2<span class="elsevierStyleHsp" style=""></span>mm-wide blood blot&#59; clot formation time &#40;CFT&#44; seconds&#41;&#44; time elapsed since the end of CT until achieving a 20<span class="elsevierStyleHsp" style=""></span>mm relatively firm clot&#59; alpha angle &#40;in degrees&#41;&#44; angle between the central line and a tangent to the curve after reaching a 2<span class="elsevierStyleHsp" style=""></span>mm-wide blood blot&#59; maximum clot firmness &#40;MCF&#44; in mm&#41;&#59; clot final resistance resulting from the interaction of fibrin&#44; activated platelets&#44; and factor XIII&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The fibrinolytic parameters included are the Lysis Index &#40;LI&#41;&#44; the Maximum Lysis &#40;ML&#41; and the Lysis Onset Time &#40;LOT&#41;&#46; The ROTEM Delta<span class="elsevierStyleSup">&#174;</span> software provides such fibrinolytic parameters automatically&#46; Maximum lysis &#40;ML&#59; &#37;&#41; describes the MCF relative reduction due to the lysis of the clot&#46; LOT &#40;seconds&#41; is the time elapsed since the beginning of the clotting reaction until reaching &#8805;15&#37; lysis of the blood clot&#46; According to the medical literature&#44; hyperfibrinolysis was defined as APTEM maximum lysis &#40;ML&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">11&#44;12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Also&#44; the following traditional clotting tests were run&#58; international normalized ratio &#40;INR&#41;&#59; activated partial thromboplastin time &#40;APTT&#41;&#44; expressed in seconds&#44; and fibrinogen concentrate&#44; expressed in mg&#47;dL&#46; The reference values provided by the center lab were used&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">When it comes to the statistical analysis&#44; the continuous variables were expressed as mean and interquartile range &#40;IQR&#41; unless specified otherwise&#46; The categorical variables were expressed as absolute and relative frequencies&#46; The study of the correlation among the different quantitative variables was conducted using the univariate linear regression analysis&#46; <span class="elsevierStyleItalic">P</span> values<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;05 were considered statistically significant&#46; The statistical analysis was conducted using the STATA 12 statistical software package &#40;StataCorp&#46; 2011&#41;&#46; The results of this study were disclosed according to the recommendations established for STROBE observational studies&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 18 patients who met the uncontrolled asystole donation criteria of the hospital protocol were included in the study&#46; No patient was excluded during the study period&#46; Fourteen &#40;14&#41; patients were males &#40;77&#46;8&#37;&#41; and the mean age of our sample was 50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;6<span class="elsevierStyleHsp" style=""></span>years&#46; The first heart rhythm recorded in the out-of-hospital care was ventricular fibrillation in 10<span class="elsevierStyleHsp" style=""></span>cases &#40;55&#46;6&#37;&#41;&#44; asystole in 5<span class="elsevierStyleHsp" style=""></span>cases &#40;27&#46;8&#37;&#41;&#44; and unknown in 3<span class="elsevierStyleHsp" style=""></span>cases&#46; During the hospital assessment for eligibility in the donation program&#44; all patients showed EKC tracings that were compatible with asystole and met the remaining criteria established&#46; The mean time elapsed from the CRA until the blood sample was collected &#40;cardiac arrest time&#41; was 91<span class="elsevierStyleHsp" style=""></span>min &#40;75&#8211;104&#41;&#46; The remaining times associated with care are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In over half the patients&#44; alterations in traditional clotting parameters were seen&#46; APPT alterations were present in almost the entire sample &#40;94&#46;1&#37;&#41; as well as hypofibrinogenemia &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The detailed results from the ROTEM analysis for the parameters on clot formation and lysis are shown on <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46; There was an increase in the times of blood clot initiation and formation &#40;APTEM&#41;&#58; CT&#44; 126<span class="elsevierStyleHsp" style=""></span>s &#40;104&#8211;191&#41;&#59; CFT&#44; 247<span class="elsevierStyleHsp" style=""></span>s &#40;203&#8211;694&#41;&#46; Fifteen &#40;15&#41; patients &#40;83&#46;3&#37;&#41; showed hyperfibrinolysis according to the criteria established&#46; In order to confirm this finding&#44; the results obtained from the EXTEM and APTEM tests were compared to one another&#46; MCF improved in the APTEM test &#40;34<span class="elsevierStyleHsp" style=""></span>mm vs 42<span class="elsevierStyleHsp" style=""></span>mm&#59; mean difference 7&#46;4<span class="elsevierStyleHsp" style=""></span>mm&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The LOT mean was 1058<span class="elsevierStyleHsp" style=""></span>s &#40;322&#8211;2365&#41;&#46; The univariate regression analysis studied the correlation between cardiac arrest time and clotting tests&#46; Longer cardiac arrest times were associated with lower levels of fibrinogen at admission &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; There was also an inverse correlation between the duration of the cardiac arrest and MCF in the FIBTEM test &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; The remaining clotting parameters and viscoelastic testing were not statistically significant when it comes to the cardiac arrest times reported&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">This study describes the ROTEM profile of a group of patients in uncontrolled asystole&#46; As far as the authors know&#44; the ROTEM profile has never been determined in a cohort of patients with these characteristics and so long cardiac arrest times&#46; The patients included in the study revealed severe clotting data in the traditional clotting tests performed and in the ROTEM system&#46; We should mention here that the incidence of hyperfibrinolysis &#40;APTEM maximum lysis<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&#37;&#41; was far more superior than previously thought&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">It has been over 40 years since CRA-related coagulopathy was first described and still few studies include viscoelastic testing&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">14&#44;15</span></a> In a series of 30<span class="elsevierStyleHsp" style=""></span>pacientes with out-of-hospital cardiac arrest&#44; the cardiac arrest mean times were 27<span class="elsevierStyleHsp" style=""></span>min and 53&#37; of the patients had hyperfibrinolysis&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a> In a new study&#44; both the APTT and CT &#40;EXTEM&#41; alterations were associated with poor prognoses&#46; In this study&#44; 35&#46;8&#37; of the patients had hyperfibrinolysis and cardiac arrest times of 21<span class="elsevierStyleHsp" style=""></span>min&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">9</span></a> The patients included in our study showed severe coagulopathy patterns both in the traditional tests performed and in the viscoelastic testing run&#46; Traditional clotting levels were out of the range of normalcy in over half of the patients together with decreased fibrinogen levels&#46; Also&#44; the incidence of hyperfibrinolysis was higher to the one described by the medical literature &#40;83&#37;&#41; and cardiac arrest times were longer &#40;91<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; We find some relevant differences in our study compared to former studies&#46; The goal of these former studies was to validate the no-reflow hypothesis and the effect of fibrinolytic drugs in patients who suffer cardiac arrests&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">16</span></a> Newer studies have confirmed the existence of predictive factors of spontaneous circulation recovery through the analysis of viscoelastic testing&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">8&#44;9</span></a> This study describes the viscoelastic pattern of a given subgroup of patients with unrecovered cardiac arrest &#40;donors in asystole&#41;&#46; Thus&#44; the times of cardiac arrest and ischemia are much longer compared to the ones already published by the medical literature&#46; Secondly&#44; but also having to do with what we just talked about&#44; the incidence of hyperfibrinolysis was higher compared to other series &#40;83&#37; vs 53 and 35&#37;&#41;&#46; Except for three &#40;3&#41; patients&#44; all of them showed hyperfibrinolysis&#46; The improved MCF and lysis correction in the APTEM test confirm these results&#46; Also&#44; we saw statistically significant associations among the cardiac arrest times&#44; the levels of fibrinogen&#44; and MCF in the FIBTEM test&#46; We attribute the higher incidence of hyperfibrinolysis to the longer cardiac arrest times of our sample&#46; This may actually reinforce the hypoperfusion hypothesis after seeing a dose&#8211;response effect between the degree of hypoperfusion &#40;cardiac arrest time&#41; and the incidence of coagulopathy and hyperfibrinolysis&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Hypoperfusion is one of the leading mechanisms involved in the development of coagulopathy and hyperfibrinolysis&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">3</span></a> The increased activated protein C &#40;APC&#41; levels in this setting can lead to the deterioration of certain clotting factors &#40;Va&#44; VIIa&#41; and induce fibrinolysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">4&#44;11&#44;17</span></a> Increased levels of t-PA &#40;tissue plasminogen activator&#41; and reduced levels of PAI-1 &#40;plasminogen activator inhibitor-1&#41; during the first phases of a CRA have been reported here&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">18</span></a> Sustaining this situation in time may explain the incidence of hyperfibrinolysis reported&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Recently&#44; the use of the ROTEM pattern has been proposed as a tool for prognostic assessment during a CRA&#46; Apart from the obvious clinical interest&#44; here we should ask ourselves whether the alterations observed in the viscoelastic testing are but a reflection of sustained hypoperfusion or they are capable of perpetuating CRA in some cases&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">19</span></a> Nevertheless&#44; we should mention here that in studies like this it is difficult to isolate the effect of hypoperfusion from other factors such as exposure to catecholamines&#44; tissue lesion or endothelial response to a combination of both&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">20&#44;21</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Our study has some limitations&#46; In this study&#44; cardiac arrest is proposed as a hypoperfusion model although this should be explained in detailed&#46; In the first place&#44; the cardiac massage during the cardiac arrest can cause chest trauma&#44; meaning that our results may not be attributable to hypoperfusion only&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a> Secondly&#44; we never knew what the D-dimer levels were in the patients included in the study&#46; The assessment of these levels may have completed the findings reported and their association with hyperfibrinolysis&#46; Finally&#44; this was a single-center study with a limited number of asystole patients&#46; Coagulopathy is one dynamic process where several phenomena coexist such as ischemia&#8211;reperfusion&#44; hyperfibrinolysis&#44; and fibrinolysis-related cardiac arrest &#40;fibrinolytic shutdown&#41;&#46; Our study only included patients with sustained hypoperfusion &#40;asystole&#41;&#44; so we cannot not provide any information on these other phenomena&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">This study tried to look into the underlying mechanisms of hypoperfusion and coagulopathy&#46; With the data collected in this study we cannot draw final conclusions for their implementation in the routine clinical practice&#44; but they can be hypothesis-generating in this area of knowledge&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding</span><p id="par0075" class="elsevierStylePara elsevierViewall">None whatsoever&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Author&#39;s contribution</span><p id="par0080" class="elsevierStylePara elsevierViewall">Original idea&#58; M&#46; Chico-Fern&#225;ndez&#44; L&#46;J&#46; Terceros-Almanza&#44; C&#46; Garc&#237;a-Fuentes&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Data mining&#58; M&#46; Valiente-Fern&#225;ndez&#44; A&#46; Rodr&#237;guez-Biendicho&#44; I&#46;J&#46; Prieto del Protillo&#44; C&#46; Mudarra-Reche&#44; S&#46; Bermejo-Azn&#225;rez&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Data analysis&#58; L&#46;J&#46; Terceros-Almanza&#44; J&#46;A&#46; Barea-Mendoza&#44; C&#46; Garc&#237;a-Fuentes&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Interpretation of results&#58; J&#46;A&#46; Barea-Mendoza&#44; L&#46;J&#46; Terceros-Almanza&#44; C&#46; Garc&#237;a-Fuentes&#44; M&#46; Chico-Fern&#225;ndez&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Writing of the manuscript&#58; J&#46;A&#46; Barea-Mendoza&#44; L&#46;J&#46; Terceros-Almanza&#44; M&#46; Chico-Fern&#225;ndez&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Review of final manuscript&#58; All authors&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest whatsoever&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hypoperfusion plays a central role in shock states&#44; and has been proposed as a coagulopathy trigger&#46; The study of the rotational thromboelastometry &#40;ROTEM&#41; profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Outcome</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Design</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest &#40;CA&#41;&#46; Initial rhythm and time between CA and admission were recorded&#46; Conventional coagulation and ROTEM &#40;EXTEM&#44; APTEM&#44; FIBTEM&#41; tests were performed within 30<span class="elsevierStyleHsp" style=""></span>min after blood sample collection&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Scope</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">An asystole donor reference hospital&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Participants</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Patients admitted to the ICU after out-of-hospital non-recovered CA&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The median age was 50<span class="elsevierStyleHsp" style=""></span>years&#44; and 14 of the patients were men &#40;77&#46;8&#37;&#41;&#46; The time from CA to hospital admission expressed as the median &#40;interquartile range&#41; was 91<span class="elsevierStyleHsp" style=""></span>min &#40;75&#8211;104&#41;&#46; The results of the routine tests were&#58; INR 1&#46;25 &#40;1&#46;19&#8211;1&#46;34&#41;&#44; aPTT 55<span class="elsevierStyleHsp" style=""></span>s &#40;45&#8211;73&#41; and fibrinogen 161<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;95&#8211;295&#41;&#46; For the ROTEM APTEM assay the results were&#58; CT 126<span class="elsevierStyleHsp" style=""></span>s &#40;104&#8211;191&#41;&#44; CFT 247<span class="elsevierStyleHsp" style=""></span>s &#40;203&#8211;694&#41;&#46; Hyperfibrinolysis criteria were recorded in 15 patients &#40;83&#46;3&#37;&#41;&#46; In addition&#44; MCF improved in APTEM versus EXTEM&#46; Prolonged CA times were associated to lower fibrinogen levels and lower values for MCF FIBTEM &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The ROTEM assays revealed severe alterations of the clot formation parameters and a high incidence of hyperfibrinolysis&#46;</p></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Introducci&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La hipoperfusi&#243;n juega un papel central en el shock&#44; y es un desencadenante de la coagulopat&#237;a&#46; El estudio del perfil ROTEM durante la parada card&#237;aca prolongada podr&#237;a ofrecer nuevos conocimientos sobre la fisiopatolog&#237;a de la coagulopat&#237;a por shock&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Describir el perfil de tromboelastometr&#237;a rotacional en una cohorte de donantes en asistolia y determinar la incidencia de hiperfibrin&#243;lisis&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Cohortes prospectivo&#46; Incluimos 18 pacientes ingresados tras parada card&#237;aca extrahospitalaria no recuperada&#46; Se recopil&#243; el primer ritmo card&#237;aco registrado&#44; los tiempos de parada y los de asistencia&#46; Al ingreso se realizaron test de coagulaci&#243;n convencional y ROTEM &#40;EXTEM&#44; APTEM&#44; FIBTEM&#41; en los 30<span class="elsevierStyleHsp" style=""></span>min tras la obtenci&#243;n de la muestra&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">El estudio se llev&#243; a cabo en un hospital de tercer nivel incluido en un programa de donaci&#243;n en asistolia&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Pacientes en parada card&#237;aca extrahospitalaria no recuperada&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">La mediana de edad fue de 50<span class="elsevierStyleHsp" style=""></span>a&#241;os y 14 de los participantes eran hombres &#40;77&#46;8&#37;&#41;&#46; La mediana de tiempo &#40;rango intercuart&#237;lico&#41; desde la parada hasta la obtenci&#243;n de muestras fue de 91<span class="elsevierStyleHsp" style=""></span>min &#40;75-104&#41;&#46; Los resultados de la coagulaci&#243;n fueron&#58; INR 1&#44;25 &#40;1&#44;19-1&#44;34&#41;&#44; TTPA 55<span class="elsevierStyleHsp" style=""></span>s &#40;45-73&#41; y fibrin&#243;geno 161<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;95-295&#41;&#46; Los resultados del ROTEM &#40;APTEM&#41;&#58; CT 126<span class="elsevierStyleHsp" style=""></span>s &#40;104-191&#41;&#44; CFT 247<span class="elsevierStyleHsp" style=""></span>s &#40;203-694&#41;&#46; En 15 &#40;83&#44;3&#37;&#41; se cumpli&#243; el criterio de hiperfibrin&#243;lisis&#46; Tambi&#233;n se observ&#243; mejor&#237;a del MCF en APTEM frente a EXTEM&#46; Tiempos m&#225;s prolongados se asociaron con niveles inferiores de fibrin&#243;geno y un MCF FIBTEM inferior &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El an&#225;lisis ROTEM mostr&#243; una profunda alteraci&#243;n en la formaci&#243;n del co&#225;gulo junto con alta incidencia de hiperfibrin&#243;lisis&#46;</p></span>"
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                  \t\t\t\t">Presence of bleeding lesions in chest and abdomen&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Presence of potentially communicable systemic infections or neoplastic disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;46&#8211;56&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference values&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Patients out of range&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobin &#40;g&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;2 &#40;12&#46;1&#8211;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#8211;45&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">PA &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">74 &#40;69&#8211;79&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;52&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">INR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;25 &#40;1&#46;19&#8211;1&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">APTT &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55 &#40;45&#8211;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#8211;39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16 &#40;94&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrinogen &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161 &#40;95&#8211;295&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">200&#8211;560&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>A5 &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MCF &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">34 &#40;17&#8211;52&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;66&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>LOT &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1058 &#40;322&#8211;2365&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Multi-centre investigation on reference ranges for ROTEM thromboelastometry"
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                        "paginaInicial" => "301"
                        "paginaFinal" => "310"
                        "link" => array:1 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis and treatment of hyperfibrinolysis in trauma &#40;a European perspective&#41;"
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                            2 => "R&#46;A&#46; Davenport"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0036-1598001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Thromb Hemost"
                        "fecha" => "2017"
                        "volumen" => "43"
                        "paginaInicial" => "224"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28219084"
                            "web" => "Medline"
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                ]
              ]
            ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Viscoelastic testing in trauma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;R&#46; Wirtz"
                            1 => "H&#46;M&#46; Baumann"
                            2 => "J&#46;H&#46; Klinkspoor"
                            3 => "J&#46;C&#46; Goslings"
                            4 => "N&#46;P&#46; Juffermans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1055/s-0037-1598057"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Thromb Hemost"
                        "fecha" => "2017"
                        "volumen" => "43"
                        "paginaInicial" => "375"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28364737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Strengthening the Reporting of Observational Studies in Epidemiology &#40;STROBE&#41; statement&#58; guidelines for reporting observational studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Von Elm"
                            1 => "D&#46;G&#46; Altman"
                            2 => "M&#46; Egger"
                            3 => "S&#46;J&#46; Pocock"
                            4 => "P&#46;C&#46; G&#248;tzsche"
                            5 => "J&#46;P&#46; Vandenbroucke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(07)61602-X"
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                        "tituloSerie" => "Lancet"
                        "fecha" => "2007"
                        "volumen" => "370"
                        "paginaInicial" => "1453"
                        "paginaFinal" => "1457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18064739"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                      "titulo" => "Disseminated intravascular coagulation following cardiac arrest&#58; a study of 15 patients"
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                          "autores" => array:4 [
                            0 => "B&#46; Mehta"
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                            2 => "S&#46;C&#46; Sommers"
                            3 => "M&#46; Karpatkin"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00000441-197211000-00002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med Sci"
                        "fecha" => "1972"
                        "volumen" => "264"
                        "paginaInicial" => "353"
                        "paginaFinal" => "363"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4650128"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0185"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Coagulofibrinolytic changes in patients with post-cardiac arrest syndrome"
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                        "paginaInicial" => "1"
                        "paginaFinal" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Activation of blood coagulation after cardiac arrest is not balanced adequately by activation of endogenous fibrinolysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "H&#46; B&#246;hrer"
                            3 => "T&#46; B&#246;ker"
                            4 => "M&#46; Aulmann"
                            5 => "P&#46;P&#46; Nawroth"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/01.cir.92.9.2572"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "1995"
                        "volumen" => "92"
                        "paginaInicial" => "2572"
                        "paginaFinal" => "2578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7586359"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inducing acute traumatic coagulopathy in vitro&#58; the effects of activated protein C on healthy human whole blood"
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                        0 => array:2 [
                          "etal" => true
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                            4 => "B&#46;Y&#46; Miyazawa"
                            5 => "R&#46;F&#46; Vilardi"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2016"
                        "volumen" => "11"
                        "paginaInicial" => "1"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tissue factor and tissue factor pathway inhibitor levels during and after cardiopulmonary resuscitation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Gando"
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                            2 => "Y&#46; Morimoto"
                            3 => "S&#46; Kobayashi"
                            4 => "O&#46; Kemmotsu"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0049-3848(99)00073-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thromb Res"
                        "fecha" => "1999"
                        "volumen" => "96"
                        "paginaInicial" => "107"
                        "paginaFinal" => "113"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10574588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Thromboelastometric analysis of the risk factors for return of spontaneous circulation in adult patients with out-of-hospital cardiac arrest"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "Y&#46; Sakamoto"
                            2 => "R&#46; Sakurai"
                            3 => "M&#46; Ohta"
                            4 => "H&#46; Imahase"
                            5 => "M&#46; Yahata"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "PLOS ONE"
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                        "paginaFinal" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Shock induced endotheliopathy &#40;SHINE&#41; in acute critical illness&#8212;a unifying pathophysiologic mechanism"
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                        0 => array:2 [
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2017"
                        "volumen" => "21"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0215"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Perturbation of the endothelial glycocalyx in post cardiac arrest syndrome"
                      "autores" => array:1 [
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                          "etal" => true
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.resuscitation.2012.01.028"
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                        "tituloSerie" => "Resuscitation"
                        "fecha" => "2012"
                        "volumen" => "83"
                        "paginaInicial" => "715"
                        "paginaFinal" => "720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22306259"
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                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "22"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Intra-thoracic injuries associated with cardiopulmonary resuscitation&#8212;Frequent and serious"
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                  "host" => array:1 [
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                        "paginaInicial" => "66"
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Original
Rotational thromboelastometry (ROTEM) profile in a cohort of asystole donors
Perfil de tromboelastometría rotacional (ROTEM) en una cohorte de asistolia no controlada
J.A. Barea-Mendoza
Corresponding author
jbareamendoza@gmail.com

Corresponding author.
, L.J. Terceros-Almanza, C. García-Fuentes, S. Bermejo-Aznárez, I.J. Prieto del Portillo, C. Mudarra-Reche, M. Valiente-Fernández, A. Rodríguez-Biendicho, J.C. Montejo González, M. Chico-Fernández
Grupo de Investigación en Trauma y Emergencias (GINTEM-12), Unidad de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
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observational study conducted at Hospital Universitario 12 de Octubre from January 2015 to January 2016&#46; Our hospital ethics committee approved the study &#40;12&#47;160&#41;&#46; All the patients from our center considered eligible to enter the program of uncontrolled asystole donation &#40;Maastricht type IIa&#41; were included in this study&#46; The procedure of this donation program is shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The initial out-of-hospital care was provided by our team of specialists in special care&#46; This out-of-hospital care team examined those patients who may be potential donors based on the aforementioned criteria&#46; After confirming the criteria&#44; the hospital service was activated as asystole code and the team proceeded with the transfer&#46; The hospital acceptance of the potential donor was conducted by the Intensive Medicine unit&#46; Upon the patient&#39;s arrival&#44; the team confirmed his death&#44; the selection criteria&#44; 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and &#40;c&#41; time elapsed since the cardiac arrest until proceeding to collect the blood samples &#40;cardiac arrest time&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In order to determine the aforementioned parameters&#44; the ROTEM Delta<span class="elsevierStyleSup">&#174;</span> system was used &#40;Tem Innovations GmbH&#44; Munich&#44; Germany&#41;&#46; The reference values already published in the medical literature were used&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">10</span></a> The ROTEM analysis was conducted within the 30<span class="elsevierStyleHsp" style=""></span>min that followed the collection of every blood sample&#46; The EXTEM &#40;ex-tem<span class="elsevierStyleSup">&#174;</span> recombinant reactive tissue factor activation&#41;&#44; APTEM &#40;same activation as EXTEM&#44; fibrinolytic activation with aprotinin&#41; and FIBTEM &#40;same activation as EXTEM&#44; platelet activation with cytochalasin D&#41; tests were run on all the blood samples collected&#46; The following variables were recorded&#58; clotting time &#40;CT&#44; seconds&#41;&#59; time elapsed since the initial measurement to the formation of a 2<span class="elsevierStyleHsp" style=""></span>mm-wide blood blot&#59; clot formation time &#40;CFT&#44; seconds&#41;&#44; time elapsed since the end of CT until achieving a 20<span class="elsevierStyleHsp" style=""></span>mm relatively firm clot&#59; alpha angle &#40;in degrees&#41;&#44; angle between the central line and a tangent to the curve after reaching a 2<span class="elsevierStyleHsp" style=""></span>mm-wide blood blot&#59; maximum clot firmness &#40;MCF&#44; in mm&#41;&#59; clot final resistance resulting from the interaction of fibrin&#44; activated platelets&#44; and factor XIII&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The fibrinolytic parameters included are the Lysis Index &#40;LI&#41;&#44; the Maximum Lysis &#40;ML&#41; and the Lysis Onset Time &#40;LOT&#41;&#46; The ROTEM Delta<span class="elsevierStyleSup">&#174;</span> software provides such fibrinolytic parameters automatically&#46; Maximum lysis &#40;ML&#59; &#37;&#41; describes the MCF relative reduction due to the lysis of the clot&#46; LOT &#40;seconds&#41; is the time elapsed since the beginning of the clotting reaction until reaching &#8805;15&#37; lysis of the blood clot&#46; According to the medical literature&#44; hyperfibrinolysis was defined as APTEM maximum lysis &#40;ML&#41;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">11&#44;12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Also&#44; the following traditional clotting tests were run&#58; international normalized ratio &#40;INR&#41;&#59; activated partial thromboplastin time &#40;APTT&#41;&#44; expressed in seconds&#44; and fibrinogen concentrate&#44; expressed in mg&#47;dL&#46; The reference values provided by the center lab were used&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">When it comes to the statistical analysis&#44; the continuous variables were expressed as mean and interquartile range &#40;IQR&#41; unless specified otherwise&#46; The categorical variables were expressed as absolute and relative frequencies&#46; The study of the correlation among the different quantitative variables was conducted using the univariate linear regression analysis&#46; <span class="elsevierStyleItalic">P</span> values<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;05 were considered statistically significant&#46; The statistical analysis was conducted using the STATA 12 statistical software package &#40;StataCorp&#46; 2011&#41;&#46; The results of this study were disclosed according to the recommendations established for STROBE observational studies&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">A total of 18 patients who met the uncontrolled asystole donation criteria of the hospital protocol were included in the study&#46; No patient was excluded during the study period&#46; Fourteen &#40;14&#41; patients were males &#40;77&#46;8&#37;&#41; and the mean age of our sample was 50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;6<span class="elsevierStyleHsp" style=""></span>years&#46; The first heart rhythm recorded in the out-of-hospital care was ventricular fibrillation in 10<span class="elsevierStyleHsp" style=""></span>cases &#40;55&#46;6&#37;&#41;&#44; asystole in 5<span class="elsevierStyleHsp" style=""></span>cases &#40;27&#46;8&#37;&#41;&#44; and unknown in 3<span class="elsevierStyleHsp" style=""></span>cases&#46; During the hospital assessment for eligibility in the donation program&#44; all patients showed EKC tracings that were compatible with asystole and met the remaining criteria established&#46; The mean time elapsed from the CRA until the blood sample was collected &#40;cardiac arrest time&#41; was 91<span class="elsevierStyleHsp" style=""></span>min &#40;75&#8211;104&#41;&#46; The remaining times associated with care are shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; In over half the patients&#44; alterations in traditional clotting parameters were seen&#46; APPT alterations were present in almost the entire sample &#40;94&#46;1&#37;&#41; as well as hypofibrinogenemia &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46; The detailed results from the ROTEM analysis for the parameters on clot formation and lysis are shown on <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#46; There was an increase in the times of blood clot initiation and formation &#40;APTEM&#41;&#58; CT&#44; 126<span class="elsevierStyleHsp" style=""></span>s &#40;104&#8211;191&#41;&#59; CFT&#44; 247<span class="elsevierStyleHsp" style=""></span>s &#40;203&#8211;694&#41;&#46; Fifteen &#40;15&#41; patients &#40;83&#46;3&#37;&#41; showed hyperfibrinolysis according to the criteria established&#46; In order to confirm this finding&#44; the results obtained from the EXTEM and APTEM tests were compared to one another&#46; MCF improved in the APTEM test &#40;34<span class="elsevierStyleHsp" style=""></span>mm vs 42<span class="elsevierStyleHsp" style=""></span>mm&#59; mean difference 7&#46;4<span class="elsevierStyleHsp" style=""></span>mm&#59; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The LOT mean was 1058<span class="elsevierStyleHsp" style=""></span>s &#40;322&#8211;2365&#41;&#46; The univariate regression analysis studied the correlation between cardiac arrest time and clotting tests&#46; Longer cardiac arrest times were associated with lower levels of fibrinogen at admission &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46; There was also an inverse correlation between the duration of the cardiac arrest and MCF in the FIBTEM test &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41; &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46; The remaining clotting parameters and viscoelastic testing were not statistically significant when it comes to the cardiac arrest times reported&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">This study describes the ROTEM profile of a group of patients in uncontrolled asystole&#46; As far as the authors know&#44; the ROTEM profile has never been determined in a cohort of patients with these characteristics and so long cardiac arrest times&#46; The patients included in the study revealed severe clotting data in the traditional clotting tests performed and in the ROTEM system&#46; We should mention here that the incidence of hyperfibrinolysis &#40;APTEM maximum lysis<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15&#37;&#41; was far more superior than previously thought&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">It has been over 40 years since CRA-related coagulopathy was first described and still few studies include viscoelastic testing&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">14&#44;15</span></a> In a series of 30<span class="elsevierStyleHsp" style=""></span>pacientes with out-of-hospital cardiac arrest&#44; the cardiac arrest mean times were 27<span class="elsevierStyleHsp" style=""></span>min and 53&#37; of the patients had hyperfibrinolysis&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a> In a new study&#44; both the APTT and CT &#40;EXTEM&#41; alterations were associated with poor prognoses&#46; In this study&#44; 35&#46;8&#37; of the patients had hyperfibrinolysis and cardiac arrest times of 21<span class="elsevierStyleHsp" style=""></span>min&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">9</span></a> The patients included in our study showed severe coagulopathy patterns both in the traditional tests performed and in the viscoelastic testing run&#46; Traditional clotting levels were out of the range of normalcy in over half of the patients together with decreased fibrinogen levels&#46; Also&#44; the incidence of hyperfibrinolysis was higher to the one described by the medical literature &#40;83&#37;&#41; and cardiac arrest times were longer &#40;91<span class="elsevierStyleHsp" style=""></span>min&#41;&#46; We find some relevant differences in our study compared to former studies&#46; The goal of these former studies was to validate the no-reflow hypothesis and the effect of fibrinolytic drugs in patients who suffer cardiac arrests&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">16</span></a> Newer studies have confirmed the existence of predictive factors of spontaneous circulation recovery through the analysis of viscoelastic testing&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">8&#44;9</span></a> This study describes the viscoelastic pattern of a given subgroup of patients with unrecovered cardiac arrest &#40;donors in asystole&#41;&#46; Thus&#44; the times of cardiac arrest and ischemia are much longer compared to the ones already published by the medical literature&#46; Secondly&#44; but also having to do with what we just talked about&#44; the incidence of hyperfibrinolysis was higher compared to other series &#40;83&#37; vs 53 and 35&#37;&#41;&#46; Except for three &#40;3&#41; patients&#44; all of them showed hyperfibrinolysis&#46; The improved MCF and lysis correction in the APTEM test confirm these results&#46; Also&#44; we saw statistically significant associations among the cardiac arrest times&#44; the levels of fibrinogen&#44; and MCF in the FIBTEM test&#46; We attribute the higher incidence of hyperfibrinolysis to the longer cardiac arrest times of our sample&#46; This may actually reinforce the hypoperfusion hypothesis after seeing a dose&#8211;response effect between the degree of hypoperfusion &#40;cardiac arrest time&#41; and the incidence of coagulopathy and hyperfibrinolysis&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Hypoperfusion is one of the leading mechanisms involved in the development of coagulopathy and hyperfibrinolysis&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">3</span></a> The increased activated protein C &#40;APC&#41; levels in this setting can lead to the deterioration of certain clotting factors &#40;Va&#44; VIIa&#41; and induce fibrinolysis&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">4&#44;11&#44;17</span></a> Increased levels of t-PA &#40;tissue plasminogen activator&#41; and reduced levels of PAI-1 &#40;plasminogen activator inhibitor-1&#41; during the first phases of a CRA have been reported here&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">18</span></a> Sustaining this situation in time may explain the incidence of hyperfibrinolysis reported&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Recently&#44; the use of the ROTEM pattern has been proposed as a tool for prognostic assessment during a CRA&#46; Apart from the obvious clinical interest&#44; here we should ask ourselves whether the alterations observed in the viscoelastic testing are but a reflection of sustained hypoperfusion or they are capable of perpetuating CRA in some cases&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">19</span></a> Nevertheless&#44; we should mention here that in studies like this it is difficult to isolate the effect of hypoperfusion from other factors such as exposure to catecholamines&#44; tissue lesion or endothelial response to a combination of both&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">20&#44;21</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Our study has some limitations&#46; In this study&#44; cardiac arrest is proposed as a hypoperfusion model although this should be explained in detailed&#46; In the first place&#44; the cardiac massage during the cardiac arrest can cause chest trauma&#44; meaning that our results may not be attributable to hypoperfusion only&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a> Secondly&#44; we never knew what the D-dimer levels were in the patients included in the study&#46; The assessment of these levels may have completed the findings reported and their association with hyperfibrinolysis&#46; Finally&#44; this was a single-center study with a limited number of asystole patients&#46; Coagulopathy is one dynamic process where several phenomena coexist such as ischemia&#8211;reperfusion&#44; hyperfibrinolysis&#44; and fibrinolysis-related cardiac arrest &#40;fibrinolytic shutdown&#41;&#46; Our study only included patients with sustained hypoperfusion &#40;asystole&#41;&#44; so we cannot not provide any information on these other phenomena&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">This study tried to look into the underlying mechanisms of hypoperfusion and coagulopathy&#46; With the data collected in this study we cannot draw final conclusions for their implementation in the routine clinical practice&#44; but they can be hypothesis-generating in this area of knowledge&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Funding</span><p id="par0075" class="elsevierStylePara elsevierViewall">None whatsoever&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Author&#39;s contribution</span><p id="par0080" class="elsevierStylePara elsevierViewall">Original idea&#58; M&#46; Chico-Fern&#225;ndez&#44; L&#46;J&#46; Terceros-Almanza&#44; C&#46; Garc&#237;a-Fuentes&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Data mining&#58; M&#46; Valiente-Fern&#225;ndez&#44; A&#46; Rodr&#237;guez-Biendicho&#44; I&#46;J&#46; Prieto del Protillo&#44; C&#46; Mudarra-Reche&#44; S&#46; Bermejo-Azn&#225;rez&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Data analysis&#58; L&#46;J&#46; Terceros-Almanza&#44; J&#46;A&#46; Barea-Mendoza&#44; C&#46; Garc&#237;a-Fuentes&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Interpretation of results&#58; J&#46;A&#46; Barea-Mendoza&#44; L&#46;J&#46; Terceros-Almanza&#44; C&#46; Garc&#237;a-Fuentes&#44; M&#46; Chico-Fern&#225;ndez&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Writing of the manuscript&#58; J&#46;A&#46; Barea-Mendoza&#44; L&#46;J&#46; Terceros-Almanza&#44; M&#46; Chico-Fern&#225;ndez&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Review of final manuscript&#58; All authors&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0110" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest whatsoever&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hypoperfusion plays a central role in shock states&#44; and has been proposed as a coagulopathy trigger&#46; The study of the rotational thromboelastometry &#40;ROTEM&#41; profile during cardiac arrest could offer new insights to the role of hypoperfusion in coagulation during shock states&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Outcome</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To describe the ROTEM profile in a cohort of asystole donors and elucidate the incidence of hyperfibrinolysis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Design</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A prospective observational study was carried out in 18 patients consecutively admitted to the ICU after out-of-hospital non-recovered cardiac arrest &#40;CA&#41;&#46; Initial rhythm and time between CA and admission were recorded&#46; Conventional coagulation and ROTEM &#40;EXTEM&#44; APTEM&#44; FIBTEM&#41; tests were performed within 30<span class="elsevierStyleHsp" style=""></span>min after blood sample collection&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Scope</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">An asystole donor reference hospital&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Participants</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Patients admitted to the ICU after out-of-hospital non-recovered CA&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The median age was 50<span class="elsevierStyleHsp" style=""></span>years&#44; and 14 of the patients were men &#40;77&#46;8&#37;&#41;&#46; The time from CA to hospital admission expressed as the median &#40;interquartile range&#41; was 91<span class="elsevierStyleHsp" style=""></span>min &#40;75&#8211;104&#41;&#46; The results of the routine tests were&#58; INR 1&#46;25 &#40;1&#46;19&#8211;1&#46;34&#41;&#44; aPTT 55<span class="elsevierStyleHsp" style=""></span>s &#40;45&#8211;73&#41; and fibrinogen 161<span class="elsevierStyleHsp" style=""></span>mg&#47;dL &#40;95&#8211;295&#41;&#46; For the ROTEM APTEM assay the results were&#58; CT 126<span class="elsevierStyleHsp" style=""></span>s &#40;104&#8211;191&#41;&#44; CFT 247<span class="elsevierStyleHsp" style=""></span>s &#40;203&#8211;694&#41;&#46; Hyperfibrinolysis criteria were recorded in 15 patients &#40;83&#46;3&#37;&#41;&#46; In addition&#44; MCF improved in APTEM versus EXTEM&#46; Prolonged CA times were associated to lower fibrinogen levels and lower values for MCF FIBTEM &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;05&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The ROTEM assays revealed severe alterations of the clot formation parameters and a high incidence of hyperfibrinolysis&#46;</p></span>"
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        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Introducci&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La hipoperfusi&#243;n juega un papel central en el shock&#44; y es un desencadenante de la coagulopat&#237;a&#46; El estudio del perfil ROTEM durante la parada card&#237;aca prolongada podr&#237;a ofrecer nuevos conocimientos sobre la fisiopatolog&#237;a de la coagulopat&#237;a por shock&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Describir el perfil de tromboelastometr&#237;a rotacional en una cohorte de donantes en asistolia y determinar la incidencia de hiperfibrin&#243;lisis&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Cohortes prospectivo&#46; Incluimos 18 pacientes ingresados tras parada card&#237;aca extrahospitalaria no recuperada&#46; Se recopil&#243; el primer ritmo card&#237;aco registrado&#44; los tiempos de parada y los de asistencia&#46; Al ingreso se realizaron test de coagulaci&#243;n convencional y ROTEM &#40;EXTEM&#44; APTEM&#44; FIBTEM&#41; en los 30<span class="elsevierStyleHsp" style=""></span>min tras la obtenci&#243;n de la muestra&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">El estudio se llev&#243; a cabo en un hospital de tercer nivel incluido en un programa de donaci&#243;n en asistolia&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Pacientes en parada card&#237;aca extrahospitalaria no recuperada&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">La mediana de edad fue de 50<span class="elsevierStyleHsp" style=""></span>a&#241;os y 14 de los participantes eran hombres &#40;77&#46;8&#37;&#41;&#46; La mediana de tiempo &#40;rango intercuart&#237;lico&#41; desde la parada hasta la obtenci&#243;n de muestras fue de 91<span class="elsevierStyleHsp" style=""></span>min &#40;75-104&#41;&#46; Los resultados de la coagulaci&#243;n fueron&#58; INR 1&#44;25 &#40;1&#44;19-1&#44;34&#41;&#44; TTPA 55<span class="elsevierStyleHsp" style=""></span>s &#40;45-73&#41; y fibrin&#243;geno 161<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;95-295&#41;&#46; Los resultados del ROTEM &#40;APTEM&#41;&#58; CT 126<span class="elsevierStyleHsp" style=""></span>s &#40;104-191&#41;&#44; CFT 247<span class="elsevierStyleHsp" style=""></span>s &#40;203-694&#41;&#46; En 15 &#40;83&#44;3&#37;&#41; se cumpli&#243; el criterio de hiperfibrin&#243;lisis&#46; Tambi&#233;n se observ&#243; mejor&#237;a del MCF en APTEM frente a EXTEM&#46; Tiempos m&#225;s prolongados se asociaron con niveles inferiores de fibrin&#243;geno y un MCF FIBTEM inferior &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Conclusiones</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El an&#225;lisis ROTEM mostr&#243; una profunda alteraci&#243;n en la formaci&#243;n del co&#225;gulo junto con alta incidencia de hiperfibrin&#243;lisis&#46;</p></span>"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as&#58; Barea-Mendoza JA&#44; Terceros-Almanza LJ&#44; Garc&#237;a-Fuentes C&#44; Bermejo-Azn&#225;rez S&#44; Prieto del Portillo IJ&#44; Mudarra-Reche C&#44; et al&#46; Perfil de tromboelastometr&#237;a rotacional &#40;ROTEM&#41; en una cohorte de asistolia no controlada&#46; Med Intensiva&#46; 2019&#59;43&#58;410&#8211;415&#46;</p>"
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                  \t\t\t\t">External look indicative of parenteral drug addiction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Presence of bleeding lesions in chest and abdomen&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Presence of potentially communicable systemic infections or neoplastic disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53 &#40;46&#8211;56&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;77&#46;78&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;27&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">74 &#40;69&#8211;79&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">INR&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">APTT &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">55 &#40;45&#8211;73&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26&#8211;39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">16 &#40;94&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fibrinogen &#40;mg&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">161 &#40;95&#8211;295&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">200&#8211;560&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;64&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CFT &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>A5 &#40;mm&#41;&nbsp;\t\t\t\t\t\t\n
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