Abstract 131: Nucleotides as Prognostic Factors for Post--Cardiac Arrest Syndrome
Introduction: In post-cardiac arrest syndrome (PCAS), morbidity and mortality are increased by cerebral and cardiac dysfunction due to whole-body ischemia/reperfusion injury. Reliable means of predicting clinical outcome in PCAS is currently not possible. ATP and related nucleotides are released from damaged tissues and cells subjected to stress including hypoxia and ischemia. Therefore, ATP release may be a useful outcome predictor. Here we assessed whether plasma nucleotide concentrations have prognostic value in PCAS.
Methods: We enrolled 14 PCAS patients (age: 69±18 years; 12 male, 2 female) admitted to the Critical Care Center in Juntendo University, Urayasu Hospital between February and December of 2011. Arterial blood samples were drawn via a radial line immediately after return of spontaneous circulation (ROSC) was achieved. Plasma nucleotide levels were assessed by HPLC analysis and correlated with clinical outcome.
Results: PCAS patients had significantly higher ATP and ADP levels than normal controls (NC; n=7; mean±SEM, *p<0.05, **p<0.01, Student’s t test; Fig. 1). Of the 14 patients we studied, seven patients died within 4 days. Of the 7 survivors, five showed good recovery (GR) while two patients lapsed into a vegetative state (VS). ATP, ADP, and AMP plasma levels in non-survivors were significantly higher than in survivors and levels of ATP and the sum of its breakdown products increased with the time needed to restore spontaneous circulation (Fig. 2).
Conclusions: We conclude that monitoring of initial plasma nucleotide levels is a useful prognostic tool to predict outcome in PCAS patients.
- © 2012 by American Heart Association, Inc.