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Background <p>The optimal duration of temperature control after out-of-hospital cardiac arrest remains uncertain. Prolonged hypothermic temperature control may affect coagulation, but clinical data remain limited. We evaluated the association between different durations of hypothermic temperature control at 33&#xa0;°C and coagulation parameters, recorded clinical safety outcomes, and 6-month neurological outcomes in patients after out-of-hospital cardiac arrest.</p> Methods <p>This single-center retrospective cohort study included 112 adult patients with out-of-hospital cardiac arrest who achieved return of spontaneous circulation and received hypothermic temperature control at 33&#xa0;°C at Beijing Chaoyang Hospital from January 2018 to June 2024. Patients were grouped by actual maintenance duration: 24&#xa0;h (<i>n</i> = 39), 48&#xa0;h (<i>n</i> = 30), or 72&#xa0;h (<i>n</i> = 43). Coagulation parameters were measured serially. Recorded occult blood positivity, lower-extremity deep vein thrombosis detected by vascular ultrasonography, transfusion requirements, survival to discharge, and 6-month neurological outcomes were compared.</p> Results <p>Compared with the 24&#xa0;h group, the 48&#xa0;h and 72&#xa0;h groups had longer activated partial thromboplastin time and lower platelet counts and D-dimer levels at corresponding time points. Thrombin time was prolonged in the 72&#xa0;h group at 72&#xa0;h. After FDR correction, statistically significant between-group differences persisted for APTT at 72&#xa0;h and 96&#xa0;h, TT at 72&#xa0;h, D-dimer at 48&#xa0;h, 72&#xa0;h, and 96&#xa0;h, and platelet count at 72&#xa0;h and 96&#xa0;h. Recorded occult blood positivity, lower-extremity deep vein thrombosis detected by vascular ultrasonography, and transfusion requirements did not differ significantly among groups. Adjusted analyses did not show significant associations between prolonged temperature control and the prespecified clinical outcomes, although several estimates had wide confidence intervals. Survival to discharge and 6-month neurological outcomes also did not differ significantly.</p> Conclusions <p>In this selected cohort of patients after out-of-hospital cardiac arrest who survived long enough to complete the assigned temperature-control protocol, hypothermic temperature control at 33&#xa0;°C for 48&#xa0;h or 72&#xa0;h was associated with temporal changes in coagulation parameters. These changes included prolonged APTT and TT and lower platelet counts and D-dimer levels at selected time points. They were not accompanied by a statistically detectable increase in recorded occult blood positivity, lower-extremity deep vein thrombosis detected by vascular ultrasonography, or transfusion requirements. Because treatment duration was not randomly assigned, early deaths were excluded, temperature-control phase may have influenced serial laboratory comparisons, and the sample size was modest, these findings should be considered exploratory and hypothesis-generating rather than definitive evidence of safety or efficacy. Prospective studies with appropriate adjustment for confounding are needed to evaluate the clinical safety of prolonged temperature control after out-of-hospital cardiac arrest.</p> Trial registration <p>Not applicable.</p>

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Association of hypothermic temperature-control duration at 33 °C with coagulation parameters after out-of-hospital cardiac arrest: a single-center retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月27日

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  • Xiaogang Wang,
  • Bo Jia,
  • Xingsheng Wang,
  • Yongchao Qin,
  • Le An,
  • Chenchen Hang,
  • Xing Zhao,
  • Rui Shao,
  • Ziren Tang

摘要

Background

The optimal duration of temperature control after out-of-hospital cardiac arrest remains uncertain. Prolonged hypothermic temperature control may affect coagulation, but clinical data remain limited. We evaluated the association between different durations of hypothermic temperature control at 33 °C and coagulation parameters, recorded clinical safety outcomes, and 6-month neurological outcomes in patients after out-of-hospital cardiac arrest.

Methods

This single-center retrospective cohort study included 112 adult patients with out-of-hospital cardiac arrest who achieved return of spontaneous circulation and received hypothermic temperature control at 33 °C at Beijing Chaoyang Hospital from January 2018 to June 2024. Patients were grouped by actual maintenance duration: 24 h (n = 39), 48 h (n = 30), or 72 h (n = 43). Coagulation parameters were measured serially. Recorded occult blood positivity, lower-extremity deep vein thrombosis detected by vascular ultrasonography, transfusion requirements, survival to discharge, and 6-month neurological outcomes were compared.

Results

Compared with the 24 h group, the 48 h and 72 h groups had longer activated partial thromboplastin time and lower platelet counts and D-dimer levels at corresponding time points. Thrombin time was prolonged in the 72 h group at 72 h. After FDR correction, statistically significant between-group differences persisted for APTT at 72 h and 96 h, TT at 72 h, D-dimer at 48 h, 72 h, and 96 h, and platelet count at 72 h and 96 h. Recorded occult blood positivity, lower-extremity deep vein thrombosis detected by vascular ultrasonography, and transfusion requirements did not differ significantly among groups. Adjusted analyses did not show significant associations between prolonged temperature control and the prespecified clinical outcomes, although several estimates had wide confidence intervals. Survival to discharge and 6-month neurological outcomes also did not differ significantly.

Conclusions

In this selected cohort of patients after out-of-hospital cardiac arrest who survived long enough to complete the assigned temperature-control protocol, hypothermic temperature control at 33 °C for 48 h or 72 h was associated with temporal changes in coagulation parameters. These changes included prolonged APTT and TT and lower platelet counts and D-dimer levels at selected time points. They were not accompanied by a statistically detectable increase in recorded occult blood positivity, lower-extremity deep vein thrombosis detected by vascular ultrasonography, or transfusion requirements. Because treatment duration was not randomly assigned, early deaths were excluded, temperature-control phase may have influenced serial laboratory comparisons, and the sample size was modest, these findings should be considered exploratory and hypothesis-generating rather than definitive evidence of safety or efficacy. Prospective studies with appropriate adjustment for confounding are needed to evaluate the clinical safety of prolonged temperature control after out-of-hospital cardiac arrest.

Trial registration

Not applicable.