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Procalcitonin after cardiac arrest - An indicator of severity of illness, ischemia-reperfusion injury and outcome.

Annborn, Martin LU ; Dankiewicz, Josef LU ; Erlinge, David LU ; Hertel, Sabine; Rundgren, Malin LU ; Smith, Gustav LU ; Struck, Joachim and Friberg, Hans LU (2013) In Resuscitation 84(6). p.782-787
Abstract
AIM: To investigate serial serum concentrations of procalcitonin (PCT) and C-reactive protein (CRP) in patients treated with mild hypothermia after cardiac arrest, and to study their association to severe infections, post cardiac arrest syndrome (PCAS) and long-term outcome. METHODS: Serum samples from cardiac arrest patients treated with mild hypothermia were collected serially at admission, 2, 6, 12, 24, 36, 48 and 72h after cardiac arrest. PCT and CRP concentrations were determined and tested for association with three definitions of infection, two surrogate markers of PCAS (circulation-SOFA and time to return of spontaneous circulation (ROSC)) and cerebral performance category (CPC) at six months. RESULTS: Eighty-four patients were... (More)
AIM: To investigate serial serum concentrations of procalcitonin (PCT) and C-reactive protein (CRP) in patients treated with mild hypothermia after cardiac arrest, and to study their association to severe infections, post cardiac arrest syndrome (PCAS) and long-term outcome. METHODS: Serum samples from cardiac arrest patients treated with mild hypothermia were collected serially at admission, 2, 6, 12, 24, 36, 48 and 72h after cardiac arrest. PCT and CRP concentrations were determined and tested for association with three definitions of infection, two surrogate markers of PCAS (circulation-SOFA and time to return of spontaneous circulation (ROSC)) and cerebral performance category (CPC) at six months. RESULTS: Eighty-four patients were included. PCT displayed an earlier release pattern than CRP with a significant increase within 2h, increasing further at 6h and onwards in patients with poor outcome. CRP increased later and continued to rise during the study period. PCT was strongly associated with circulation-SOFA and time to ROSC, and predicted a poor neurologic outcome with high accuracy (area under the receiver operating characteristic curve of 0.88, 0.86 and 0.87 at 12, 24 and 48h respectively). No association of PCT or CRP to infection was observed. CONCLUSION: Our results suggest that PCT is released early after resuscitation following cardiac arrest, is associated with markers of PCAS but not with infection, and is an accurate predictor of poor outcome. Validation of these findings in larger studies is warranted. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Resuscitation
volume
84
issue
6
pages
782 - 787
publisher
Elsevier
external identifiers
  • wos:000320996800027
  • pmid:23313427
  • scopus:84879888133
ISSN
1873-1570
DOI
10.1016/j.resuscitation.2013.01.004
language
English
LU publication?
yes
id
6d24499a-c8e0-4210-bf64-814b47c42aa0 (old id 3438772)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23313427?dopt=Abstract
date added to LUP
2013-02-04 13:00:06
date last changed
2019-05-19 03:18:00
@article{6d24499a-c8e0-4210-bf64-814b47c42aa0,
  abstract     = {AIM: To investigate serial serum concentrations of procalcitonin (PCT) and C-reactive protein (CRP) in patients treated with mild hypothermia after cardiac arrest, and to study their association to severe infections, post cardiac arrest syndrome (PCAS) and long-term outcome. METHODS: Serum samples from cardiac arrest patients treated with mild hypothermia were collected serially at admission, 2, 6, 12, 24, 36, 48 and 72h after cardiac arrest. PCT and CRP concentrations were determined and tested for association with three definitions of infection, two surrogate markers of PCAS (circulation-SOFA and time to return of spontaneous circulation (ROSC)) and cerebral performance category (CPC) at six months. RESULTS: Eighty-four patients were included. PCT displayed an earlier release pattern than CRP with a significant increase within 2h, increasing further at 6h and onwards in patients with poor outcome. CRP increased later and continued to rise during the study period. PCT was strongly associated with circulation-SOFA and time to ROSC, and predicted a poor neurologic outcome with high accuracy (area under the receiver operating characteristic curve of 0.88, 0.86 and 0.87 at 12, 24 and 48h respectively). No association of PCT or CRP to infection was observed. CONCLUSION: Our results suggest that PCT is released early after resuscitation following cardiac arrest, is associated with markers of PCAS but not with infection, and is an accurate predictor of poor outcome. Validation of these findings in larger studies is warranted.},
  author       = {Annborn, Martin and Dankiewicz, Josef and Erlinge, David and Hertel, Sabine and Rundgren, Malin and Smith, Gustav and Struck, Joachim and Friberg, Hans},
  issn         = {1873-1570},
  language     = {eng},
  number       = {6},
  pages        = {782--787},
  publisher    = {Elsevier},
  series       = {Resuscitation},
  title        = {Procalcitonin after cardiac arrest - An indicator of severity of illness, ischemia-reperfusion injury and outcome.},
  url          = {http://dx.doi.org/10.1016/j.resuscitation.2013.01.004},
  volume       = {84},
  year         = {2013},
}