Clinical and Experimental Emergency Medicine

The Korean Society of Emergency Medicine (대한응급의학회)
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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

  • Kim, Min-Jung (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Kim, Taegyun (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Suh, Gil Joon (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Kwon, Woon Yong (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Kim, Kyung Su (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Jung, Yoon Sun (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Ko, Jung-In (Division of Critical Care Medicine, Department of Emergency Medicine, Seoul National University Hospital) ;
  • Shin, So Mi (Department of Emergency Medicine, Seoul National University Hospital) ;
  • Lee, A Reum (Department of Emergency Medicine, Seoul National University Hospital)
  • Received : 2017.08.16
  • Accepted : 2017.10.24
  • Published : 2018.12.31
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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.

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References

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