The aim of the research was to assess whether concentrations of inflammatory markers in blood of patients after cardiac arrest (CA) are related to clinical state and survival.
Material and methods: Forty-six patients after CA, 21 after out-of-hospital and 25 after in-hospital CA, in the age 63±12 years, were enrolled. Clinical state of them was evaluated by means of Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE II). In the day next to the day of CA (day-1) and in the following day (day-2) were measured blood concentrations of high specific C-reactive protein (hs-CRP), tumor necrosis factor TNF-alfa, interleukin10 (Ile-10) and interleukin-6 (Ile-6). 25 patients survived after CA and were discharged from hospital (CA-S), 21 died during hospitalization (CA-D).
Results: In CA-D patients, compared with CA-S, we found significantly higher concentrations of hs-CRP (in day-1 19±5 vs 15±4, in day-2 21±3 vs 16±5 mg/l, P<0,001) and Ile-6 (in day-1 24.9±19.8 vs 9.2±11.3, in day-2 24.2±19.7 vs 6.9±6.8 IU/ml, P<0,001). Concentrations of TNF-alfa were greater in CA-D than in CA-S in day-1 (0.42±0.75 vs 0.18±0.21 IU/ml, P<0.04).
Concentrations of hs-CRP and Ile-6 were correlated with values of GCS and APACHE II. Using logistic regression analysis significant relation of concentrations of hs-CRP and Ile-6 in day-1 and in day-2 with survival after CA was proven.
Conclusion: Early strong immunoinflammatory reaction, expressed in higher concentrations of Ile-6, hs-CRP or TNF-alfa, is correlated not only with worse clinical state of patients after CA but with diminished survival of them, as well.
03 - 07 May 2008
European Society of Endocrinology