Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2008) 16 P255

ECE2008 Poster Presentations Diabetes and cardiovascular diseases (90 abstracts)

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

Anna Samborska-Sablik 1 , Zbigniew Sablik 2 , Wojciech Gaszynski 4 , Jan Henryk Goch 2 & Krzysztof Kula 4


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).

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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