The role of the immunoinflammatory response after cardiac arrest
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Submission date: 2009-10-12
Final revision date: 2010-01-01
Acceptance date: 2010-01-12
Online publication date: 2011-09-02
Publication date: 2010-09-02
Arch Med Sci 2011;7(4):570-571
Background: 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. Methods: 46 patients, aged 63±12 years, 21 of them after out-of-hospital CA and 25 after in-hospital CA, were enrolled to the study. 25 patients survived and were discharged from hospital (CA-S), 21 died during hospitalization (CA-D). The clinical state of the patients was evaluated by the Glasgow Coma Scale (GCS) and the Acute Physiology and Chronic Health Evaluation II (APACHE II). In the day immediately after CA (day-1) and in the following day (day-2) the plasma concentration of high specific C-reactive protein (hs-CRP), tumor necrosis factor TNF-alfa, interleukin-10 and interleukin-6 (Ile-6) were measured. Results: In CA-D patients, compared with CA-S, a significantly higher concentration 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) was found. The level of TNF-alfa was greater in CA-D 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 the scores of GCS and APACHE II. Using logistic regression analysis and the ROC curves a prognostic value of hs-CRP and Ile-6 for survival was proven. Conclusion: Post-cardiac arrest immunoinflammatory response, reflected mainly in elevated plasma concentration of hs-CRP and Ile-6, is not only correlated with patients’ clinical state but also with prediction of survival.
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