Clin Exp Emerg Med.  2018 Dec;5(4):211-218. 10.15441/ceem.17.267.

Association between the simultaneous decrease in the levels of soluble vascular cell adhesion molecule-1 and S100 protein and good neurological outcomes in cardiac arrest survivors

Affiliations
  • 1Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea. kimtaegyun@snuh.org
  • 2Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.

Abstract


OBJECTIVE
This study aimed to determine whether simultaneous decreases in the serum levels of cell adhesion molecules (intracellular cell adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin) and S100 proteins within the first 24 hours after the return of spontaneous circulation were associated with good neurological outcomes in cardiac arrest survivors.
METHODS
This retrospective observational study was based on prospectively collected data from a single emergency intensive care unit (ICU). Twenty-nine out-of-hospital cardiac arrest survivors who were admitted to the ICU for post-resuscitation care were enrolled. Blood samples were collected at 0 and 24 hours after ICU admission. According to the 6-month cerebral performance category (CPC) scale, the patients were divided into good (CPC 1 and 2, n=12) and poor (CPC 3 to 5, n=17) outcome groups.
RESULTS
No difference was observed between the two groups in terms of the serum levels of ICAM-1, VCAM-1, E-selectin, and S100 at 0 and 24 hours. A simultaneous decrease in the serum levels of VCAM-1 and S100 as well as E-selectin and S100 was associated with good neurological outcomes. When other variables were adjusted, a simultaneous decrease in the serum levels of VCAM-1 and S100 was independently associated with good neurological outcomes (odds ratio, 9.285; 95% confidence interval, 1.073 to 80.318; P=0.043).
CONCLUSION
A simultaneous decrease in the serum levels of soluble VCAM-1 and S100 within the first 24 hours after the return of spontaneous circulation was associated with a good neurological outcome in out-of-hospital cardiac arrest survivors.

Keyword

Cardiac arrest; Cardiopulmonary resuscitation; Blood-brain barrier; Endothelium

MeSH Terms

Blood-Brain Barrier
Cardiopulmonary Resuscitation
Cell Adhesion
Cell Adhesion Molecules
E-Selectin
Emergencies
Endothelium
Heart Arrest*
Humans
Intensive Care Units
Intercellular Adhesion Molecule-1
Observational Study
Out-of-Hospital Cardiac Arrest
Prospective Studies
Retrospective Studies
S100 Proteins
Survivors*
Vascular Cell Adhesion Molecule-1*
Cell Adhesion Molecules
E-Selectin
Intercellular Adhesion Molecule-1
S100 Proteins
Vascular Cell Adhesion Molecule-1
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