Association between dose of catecholamines and markers of organ injury early after out-of-hospital cardiac arrest
Czerwińska-Jelonkiewicz, Katarzyna (Royal Brompton and Harefield NHS Foundation Trust (Londres, Regne Unit))
Wood, Alice (Leicester General Hospital (Leicester, Regne Unit))
Bohm, Allan (National Institute of Cardiovascular Diseases)
Kwasiborski, Przemysław (Warsaw Medical University)
Oleksiak, Anna (National Institute of Cardiology)
Ryczek, Robert (Military Institute of Medicine)
Grand, Johannes (University Hospital of Copenhagen)
Tavazzi, Guido (University of Pavia)
Sionis, Alessandro (Institut d'Investigació Biomèdica Sant Pau)
Stępińska, Janina (National Institute of Cardiology)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Catecholamines are recommended as first-line drugs to treat hemodynamic instability after out-of-hospital cardiac arrest (OHCA). The benefit-to-risk ratio of catecholamines is dose dependent, however, their effect on metabolism and organ function early after OHCA has not been investigated. The Post-Cardiac Arrest Syndrome (PCAS) pilot study was a prospective, observational, multicenter study. The primary outcomes of this analysis were association between norepinephrine/ /cumulative catecholamines doses and neuron specific enolase (NSE)/lactate concentration over the first 72 hours after resuscitation. The association was adjusted for proven OHCA mortality predictors and verified with propensity score matching (PSM). Overall 148 consecutive OHCA patients; aged 18-91 (62. 9 ± 15. 27), 41 (27. 7%) being female, were included. Increasing norepinephrine and cumulative catecholamines doses were significantly associated with higher NSE concentration on admission (r = 0. 477, p < 0. 001; r = 0. 418, p < 0. 001) and at 24 hours after OHCA (r = 0. 339, p < 0. 01; r = 0. 441, p < 0. 001) as well as with higher lactate concentration on admission (r = 0. 404, p < 0. 001; r = 0. 280, p < 0. 01), at 24 hours (r = 0. 476, p < 0. 00; r = 0. 487, p < 0. 001) and 48 hours (r = 0. 433, p < 0. 01; r = 0. 318, p = 0. 01) after OHCA. The associations remained significant up to 48 hours in non-survivors after PSM. Increasing dose of catecholamines is associated with higher lactate and NSE concentration, which may suggest their importance for tissue oxygen delivery, anaerobic metabolism, and organ function early after OHCA.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Cardiac arrest ; Catecholamines ; Metabolism after cardiac arrest ; Organ failure after cardiac arrest ; Out-of-hospital cardiac arrest
Publicat a:	Cardiology Journal, Vol. 30 Núm. 6 (january 2023) , p. 946-956, ISSN 1898-018X

DOI: 10.5603/CJ.a2021.0173
PMID: 34967939

11 p, 263.9 KB

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