Investigation of biomarker variations post-return of spontaneous circulation following an out-of-hospital cardiac arrest

Golea, Adela; Rusu, Adriana; Dumulesc, Christiana; Bala, Cornelia

doi:10.1515/rrlm-2017-0012

Cited by 1 publication

(8 citation statements)

References 22 publications

(19 reference statements)

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“…34 Presepsin measured within 12 h of ROSC was not associated with 30-day mortality. 47 Admission IL-8 was associated with in-hospital and one-week mortality in two separate unadjusted studies, but two other studies found no significant differences between the outcome groups. 11,18,69,70 Intrathecal but not plasma IL-8 on day two was significantly higher in patients with poor six-month neurological outcomes.…”

Section: Other Inflammatory Markersmentioning

confidence: 95%

“…68 It was evaluated as a prognostic marker in three studies. 3,34,47 In a study by Pekkarinen et al, presepsin at ICU admission was associated with 12-month poor neurologic outcome and ICU death, but the association was no longer significant in a multivariable model. 3 Another study, on the contrary, reported admission presepsin to be an independent prognostic marker for a 28-day outcome.…”

Section: Other Inflammatory Markersmentioning

confidence: 98%

“…CRP is an acute-phase protein released by hepatocytes, where its transcription is induced mainly by IL-6 and IL-1β. 41 Thirteen individual studies with a total of 3005 patients evaluated CRP as a prognostic marker, 12,13,16,20,21,25,27,33,[42][43][44][45][46][47] and four studies with 792 patients assessed high-sensitivity CRP (hsCRP). 19,39,48,49 While conventional CRP assays have a detection limit of 3 to 8 mg/L, hsCRP assays can detect CRP levels as low as 0.3 mg/L.…”

Section: C-reactive Proteinmentioning

confidence: 99%

“…45 Studies on later time points reported conflicting results: Kim et al reported unadjusted association with outcome on days one to three, 44 an independent association on day two, 16,48,49 whereas three studies found no association at any time point. 12,13,19,47 Most of these studies also reported negative results for other time points. Pekkarinen et al…”

Section: C-reactive Proteinmentioning

confidence: 99%

“…IL-6, PCT and CRP at different time points after ROSC in poor outcome (CPC 3-5 or nonsurvivor) and good outcome (CPC 1-2 or survivor) groups. Data were extracted from studies where inflammatory marker concentrations were available for both outcome groups 3,16,[19][20][21][22][23][24][25][26]33,36,37,40,[42][43][44][45]47,49. Concentrations were calculated as sample size weighted means of median values.…”

mentioning

confidence: 99%

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Inflammatory response after out‐of‐hospital cardiac arrest—Impact on outcome and organ failure development

Seppa

Skrifvars

Pekkarinen

2023

Acta Anaesthesiol Scand

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BackgroundPost‐cardiac arrest syndrome that occurs in out‐of‐hospital cardiac arrest (OHCA) patients is characterized by inflammatory response. We conducted a scoping review of current evidence regarding several inflammatory markers' usefulness for assessment of patient outcome and illness severity. We also discuss the proposed underlying mechanisms leading to inflammatory response after OHCA.MethodsWe searched the MEDLINE, PubMed Central, Cochrane CENTRAL and Web of Science Core Collection databases with the following search terms: (“inflammation” OR “cytokines”) AND “out‐of‐hospital cardiac arrest.” Each inflammatory marker found was combined with “out‐of‐hospital cardiac arrest” using “AND” to find further relevant studies. We included original studies measuring inflammatory markers in adult OHCA patients that assessed their prognostic capabilities for mortality, neurological outcome, or organ failure severity.ResultsFifty‐nine studies met the inclusion criteria, covering in total 65 different markers. Interleukin‐6 (IL‐6), procalcitonin (PCT) and C‐reactive protein (CRP) were the most studied markers, and they were associated with poor outcomes in 13/15, 13/14 and 11/17 studies, respectively. Based on area under the receiver operating characteristic curve (AUC) value, the time point of best discriminatory capacity for poor outcome was ICU admission for IL‐6 (median AUC 0.78, range 0.71–0.98) and day one after OHCA for PCT (median AUC 0.84, range 0.61–0.98). Seven studies reported AUCs for CRP (range 0.52–0.76) with no measurement time point being superior to others. The association of IL‐6 and PCT with outcome appeared stronger in studies with more severely ill patients. Studies reported conflicting results regarding each marker's association with organ failure severity.ConclusionInflammatory markers are potentially useful for early risk stratification after OHCA. PCT and IL‐6 have moderate prognostic value during the first 24 h of the ICU stay. Predictive accuracy appears to be associated with the study overall event rate.

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