Endocrine Abstracts (2008) 16 P255

Importance of vasopressin and aldosterone for clinical outcome of patients after cardiac arrest

Anna Samborska-Sablik1, Zbigniew Sablik2, Wojciech Gaszynski4, Jan Henryk Goch2 & Krzysztof Kula4


1Department of Emergency Medicine and Disaster Medicine of Medical University of Lodz, Lodz, Poland; 2I Department of Cardiology and Cardiac Surgery of Medical University of Lodz, Lodz, Poland; 3Department of Andrology and Fertility Medicine of Medical University of Lodz, Lodz, Poland; 4Chair of Anestesiology and Intensive Therapy of Medical University of Lodz, Lodz, Poland.


Aim: Assessment of possible role of arginine vasopressin (AVP) and aldosterone (Ald), hormones managing blood pressure and water-electrolyte balance, for clinical state and survival of patents after cardiac arrest (CA).

Material and methods: Fifty-two patients after CA in the age 62±13 years, 29 patients after out-of-hospital CA, 23 after in-hospital CA. Twenty-eight patients died after CA (CA-D), 24 survived (CA-S). In each day after CA clinical state of the patients was assessed by common scales applied in intensive care: GCS, APACHE II, SAPS II and MODS. Just after CA and in 2 following days at 8.00 a.m. blood venous samples were taken from each patient to measure typical laboratory parameters and concentration of AVP and Ald.

Results: Mean concentration of AVP was higher in CA-D than in CA-S in each day after CA. Significant correlations were found among concentrations of AVP in first two days after CA and values of the scales. In CA-D, compared to CA-S, concentration of Ald was higher in each day, significantly in the 3rd one after CA (500±507 vs 235±230 pmol/l, P<0.04). Significant relation to fatal outcome was found for concentration of AVP>83 pmol/l, assessed just after CA, in logistic regression analysis (LRA) (OR=0.23 for survival, P<0.01) and in Kaplan–Meyer survival analysis (SurA) (P<0.02), and for concentration of Ald >222 pmol/l, measured in the 3rd day after CA, in LRA (OR=0.18 for survival, P<0.02) and in SurA (P<0.04).

Conclusions:
1-AVP is involved in protecting survival in the early stage after CA, Ald plays important role in mechanisms responsible for survival in further stages after CA.

2-High concentration of AVP just after CA and markedly elevated concentration of Ald in the 3rd day after CA are markers of bad prognosis.

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