On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation
Background. It is not predictable which patients will develop a severe inflammatory response after successful cardiopulmonary resuscitation (CPR), also known as “postcardiac arrest syndrome.” This pathology affects only a subgroup of cardiac arrest victims. Whole body ischemia/reperfusion and prolon...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Mediators of Inflammation |
| Online Access: | http://dx.doi.org/10.1155/2019/8071619 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850220161185873920 |
|---|---|
| author | V. Bogner-Flatz M. Braunstein L. E. Ocker T. Kusmenkov J. Tschoep L. Ney W. Böcker T. Annecke |
| author_facet | V. Bogner-Flatz M. Braunstein L. E. Ocker T. Kusmenkov J. Tschoep L. Ney W. Böcker T. Annecke |
| author_sort | V. Bogner-Flatz |
| collection | DOAJ |
| description | Background. It is not predictable which patients will develop a severe inflammatory response after successful cardiopulmonary resuscitation (CPR), also known as “postcardiac arrest syndrome.” This pathology affects only a subgroup of cardiac arrest victims. Whole body ischemia/reperfusion and prolonged shock states after return of spontaneous circulation (ROSC) may both contribute to this devastating condition. The vascular endothelium with its glycocalyx is especially susceptible to initial ischemic damage and may play a detrimental role in the initiation of postischemic inflammatory reactions. It is not known to date if an immediate early damage to the endothelial glycocalyx, detected by on-the-scene blood sampling and measurement of soluble components (hyaluronan and syndecan-1), precedes and predicts multiple organ failure (MOF) and survival after ROSC. Methods. 15 patients after prehospital resuscitation were included in the study. Serum samples were collected on the scene immediately after ROSC and after 6 h, 12 h, 24 h, and 48 h. Hyaluronan and syndecan-1 were measured by ELISA. We associated the development of multiple organ failure and 30-day survival rates with these serum markers of early glycocalyx damage. Results. Immediate serum hyaluronan concentrations show significant differences depending on 30-day survival. Further, the hyaluronan level is significantly higher in patients developing MOF during the initial and intermediate resuscitation period. Also, the syndecan-1 levels are significantly different according to MOF occurrence. Conclusion. Serum markers of glycocalyx shedding taken immediately on the scene after ROSC can predict the occurrence of multiple organ failure and adverse clinical outcome in patients after cardiac arrest. |
| format | Article |
| id | doaj-art-77e613e4fab3486085b2e7b435e2a4bf |
| institution | OA Journals |
| issn | 0962-9351 1466-1861 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Mediators of Inflammation |
| spelling | doaj-art-77e613e4fab3486085b2e7b435e2a4bf2025-08-20T02:07:09ZengWileyMediators of Inflammation0962-93511466-18612019-01-01201910.1155/2019/80716198071619On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and ResuscitationV. Bogner-Flatz0M. Braunstein1L. E. Ocker2T. Kusmenkov3J. Tschoep4L. Ney5W. Böcker6T. Annecke7Department of Trauma Surgery, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Trauma Surgery, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Trauma Surgery, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Trauma Surgery, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Anaesthesiology, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Anaesthesiology, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Trauma Surgery, Ludwig Maximilian University Hospital Munich, Nussbaumstr. 20, 80336 Munich, GermanyDepartment of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, GermanyBackground. It is not predictable which patients will develop a severe inflammatory response after successful cardiopulmonary resuscitation (CPR), also known as “postcardiac arrest syndrome.” This pathology affects only a subgroup of cardiac arrest victims. Whole body ischemia/reperfusion and prolonged shock states after return of spontaneous circulation (ROSC) may both contribute to this devastating condition. The vascular endothelium with its glycocalyx is especially susceptible to initial ischemic damage and may play a detrimental role in the initiation of postischemic inflammatory reactions. It is not known to date if an immediate early damage to the endothelial glycocalyx, detected by on-the-scene blood sampling and measurement of soluble components (hyaluronan and syndecan-1), precedes and predicts multiple organ failure (MOF) and survival after ROSC. Methods. 15 patients after prehospital resuscitation were included in the study. Serum samples were collected on the scene immediately after ROSC and after 6 h, 12 h, 24 h, and 48 h. Hyaluronan and syndecan-1 were measured by ELISA. We associated the development of multiple organ failure and 30-day survival rates with these serum markers of early glycocalyx damage. Results. Immediate serum hyaluronan concentrations show significant differences depending on 30-day survival. Further, the hyaluronan level is significantly higher in patients developing MOF during the initial and intermediate resuscitation period. Also, the syndecan-1 levels are significantly different according to MOF occurrence. Conclusion. Serum markers of glycocalyx shedding taken immediately on the scene after ROSC can predict the occurrence of multiple organ failure and adverse clinical outcome in patients after cardiac arrest.http://dx.doi.org/10.1155/2019/8071619 |
| spellingShingle | V. Bogner-Flatz M. Braunstein L. E. Ocker T. Kusmenkov J. Tschoep L. Ney W. Böcker T. Annecke On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation Mediators of Inflammation |
| title | On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation |
| title_full | On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation |
| title_fullStr | On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation |
| title_full_unstemmed | On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation |
| title_short | On-the-Scene Hyaluronan and Syndecan-1 Serum Concentrations and Outcome after Cardiac Arrest and Resuscitation |
| title_sort | on the scene hyaluronan and syndecan 1 serum concentrations and outcome after cardiac arrest and resuscitation |
| url | http://dx.doi.org/10.1155/2019/8071619 |
| work_keys_str_mv | AT vbognerflatz onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT mbraunstein onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT leocker onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT tkusmenkov onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT jtschoep onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT lney onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT wbocker onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation AT tannecke onthescenehyaluronanandsyndecan1serumconcentrationsandoutcomeaftercardiacarrestandresuscitation |