Sympathoadrenal activation and endothelial damage are inter correlated and predict increased mortality in patients resuscitated after out-of-hospital cardiac arrest. a post Hoc sub-study of patients from the TTM-trial

PloS One
Pär I JohanssonSisse Rye Ostrowski

Abstract

Sympathoadrenal activation and endothelial damage are hallmarks of acute critical illness. This study investigated their association and predictive value in patients resuscitated from out-of-hospital cardiac arrest (OHCA). Post-hoc analysis of patients included at a single site in The Targeted Temperature Management at 33 degrees versus 36 degrees after Cardiac Arrest (TTM) trial. The main study reported similar outcomes with targeting 33 versus 36 degrees. TTM main study ClinicalTrials.gov: NCT01020916. One hundred sixty three patients resuscitated from OHCA were included at a single site ICU. Blood was sampled a median 135 min (Inter Quartile Range (IQR) 103-169) after OHCA. Plasma catecholamines (adrenaline, noradrenaline) and serum endothelial biomarkers (syndecan-1, thrombomodulin, sE-selectin, sVE-cadherin) were measured at admission (immediately after randomization). We had access to data on demography, medical history, characteristics of the OHCA, patients and 180-day outcome. Adrenaline and noradrenaline correlated positively with syndecan-1 and thrombomodulin i.e., biomarkers reflecting endothelial damage (both p<0.05). Overall 180-day mortality was 35%. By Cox analyses, plasma adrenaline, serum sE-selectin, reflectin...Continue Reading

Associated Clinical Trials

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Citations

May 19, 2019·Journal of Thrombosis and Haemostasis : JTH·Satoshi Gando, Takeshi Wada
Apr 25, 2019·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Johannes GrandChristian Hassager
Feb 19, 2020·Journal of Veterinary Emergency and Critical Care·Sarah GaudetteManuel Boller
Sep 21, 2019·European Heart Journal. Acute Cardiovascular Care·John Bro-JeppesenSteffen Thiel
Jul 12, 2020·Internal and Emergency Medicine·Simone SavastanoAlessandra Palo
Feb 10, 2017·Critical Care : the Official Journal of the Critical Care Forum·Pär Ingemar JohanssonSisse Rye Ostrowski
Dec 12, 2018·Journal of Intensive Care Medicine·Christopher JouJignesh K Patel
May 26, 2017·Current Treatment Options in Cardiovascular Medicine·Carolina B MacielDavid M Greer
May 5, 2016·Annals of Surgery·Pär I JohanssonSisse R Ostrowski
Jul 28, 2020·Clinica Chimica Acta; International Journal of Clinical Chemistry·João BessaTeresa Sousa
Jun 15, 2021·Resuscitation·Viktoriia ChabanSøren Erik Pischke
Jul 15, 2021·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Michael ThøgersenChristian Hassager

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Methods Mentioned

BETA
coronary artery bypass

Clinical Trials Mentioned

NCT01020916

Software Mentioned

SAS

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