Concentration of vasopressin and of N- terminated naturetic propeptyde type B potent predictors of survival of patients after cardiac arrest
Anna Samborska-Sablik1, Zbigniew Sablik2, Wojciech Gaszynski3, Jan Henryk Goch2 & Krzysztof Kula4
Aim: To assess concentration (conc) of arginine vasopressin (AVP) and conc of N- terminated naturetic propeptyde type B (NTpBNP) in patients (pts) after cardiac arrest (CA) and their role for clinical state of pts after CA.
Material: 52 pts after CA, 36 men and 16 women, in the age 62±13 years. CA was caused by ventricular fibrillation in 31 cases, by asystolia in 15 and by pulseless electrical activity in 6. 28 pts died after CA (P-CA-D), 24 survived and were discharged from hospital (P-CA-S).
Methods: Clinical state of pts after CA was assessed by common scales used in critical care: Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE II). Venous blood samples to measure conc of AVP and NTpBNP were taken from each patient just after admission to hospital and in 2 consecutive days at 8.00.
Results: Just after CA mean conc of AVP was higher in P-CA-D than in P-CA-S (87±58 vs 60±46 pmol/l, but P<0.1). Mean conc of NTpBNP was higher in P-CA-D in 3 consecutive days, significantly in 1 day after CA (11,4000±112000 vs 45000±58,000 pmol/l, P<0.027).
In logistic regression analysis as well in Kaplan-Meyer survival analysis an important relation between conc of AVP just after CA and survival after CA, and between levels of NTpBNP just after CA and in first day after CA and survival was revealed.
We proved negative correlations among blood conc of AVP, conc of NTpBNP and values of GCS and positive correlations among levels of them and values of APACHE II.
Conclusions: 1-Mechanisms involving biological function of AVP and of brain naturetic peptide play an important role for covalescence in early stage after CA.
2- Conc of AVP and NTpBNP are important predictors of survival after CA.