J Korean Soc Emerg Med.  2016 Apr;27(2):173-181. 10.0000/jksem.2016.27.2.173.

Changes in Inflammatory Cytokines during Rewarming Period of Therapeutic Hypothermia for Post-Cardiac Arrest Patients

• Lee HJ
• Suh GJ
• Kwon WY
• Kim KS
• Jung YS
• You KM
• Kye Y

• KMID: 2164247
• DOI: http://doi.org/10.0000/jksem.2016.27.2.173

Abstract

PURPOSE
Therapeutic hypothermia is an important treatment strategy for control of the overwhelming inflammatory reactions of cardiac arrest patients. Rapid rewarming is related to poor outcome, however the kinds of inflammatory processes that occur during the rewarming period are not well understood. Our aim in the current study was to evaluate the changes in inflammatory cytokine levels during cardiac arrest patients' rewarming period.
METHODS
This study was conducted in an emergency intensive care unit of a tertiary referral hospital. Blood samples were collected on admission (0 h) and 24, 26, 28, and 32 h after return of spontaneous circulation. Eight inflammatory cytokines (E-selectin, soluble ICAM, interleukin-10, interleukin-1ra, interleukin-6, interleukin-8, monocyte chemotactic protein-1, and tumor necrosis factor-α) were measured.
RESULTS
Twenty-eight patients were enrolled and completed a protocol of 24 h hypothermia and 8h rewarming. Eight patients were of the good cerebral performance category (CPC) and 20 of the bad. The IL-1Ra level in the good CPC group was statistically changed at 26 (p=0.039) and 28 (p=0.003) but not at 32 h (p=0.632) when compared with the 24 h level. The IL-10 levels of the bad CPC group were decreased at 26 (p=0.017) and 28h (p=0.013) but not at 32 h (p=0.074) when compared with 24 h. None of the other cytokines showed meaningful differences during the rewarming period.
CONCLUSION
Change in inflammatory-cytokine-level change during the rewarming period is not significant.

Keyword

Hypothermia induced; Heart arrest; Cytokines; Prognosis

MeSH Terms

Chemokine CCL2
Cytokines*
Emergencies
Heart Arrest
Humans
Hypothermia
Hypothermia, Induced*
Intensive Care Units
Interleukin 1 Receptor Antagonist Protein
Interleukin-10
Interleukin-6
Interleukin-8
Necrosis
Prognosis
Rewarming*
Tertiary Care Centers
Chemokine CCL2
Cytokines
Interleukin 1 Receptor Antagonist Protein
Interleukin-10
Interleukin-6
Interleukin-8