Investigation of biomarker variations post-return of spontaneous circulation following an out-of-hospital cardiac arrest

Abstract

Objective: The objective of this research was to describe evolution of several biomarkers post-return of spontaneous circulation (ROSC) following an out-of-hospital cardiac arrest (OHCA). Methods: Thirteen adult patients were divided in 2 groups according to their survival status at 30 days, survivors (alive at 30 days or discharged alive) and non-survivors (not alive at 30 days). Glycemia, lactate, C-reactive protein (CRP), neurofilament heavy chain (NfH) and presepsin were assessed at pre-set time-points, during OHCA and the first 72 hours post-ROSC. Results: In survivors, lactate levels decreased steadily throughout the 72 hours from a maximum observed during OHCA; in non-survivors, it increased during ROSC, then decreased abruptly at 2 hours post-ROSC and remained lower than in survivors for up to 24 hours. Glycemia at all-time points within the first 24 hours and CRP levels at 2 hours post-ROSC were higher in non-survivors, but this observed difference was not statistically significant. The variation of NfH was bi-modal, with peaks at 12 and 48 hours. The interpretation of NfH was limited by the large number of samples outside the limit of detection. Conclusion: Glycemia, lactate and CRP showed different patterns of evolution in survivors and non-survivors and should be further investigated as potential predictors of survival after ROSC