Abstract 212: Association of Glycocalyx Shedding and Outcomes in Patients After Cardiac Arrest: A Prospective Observational Study

Abstract

Background: The glycocalyx sheds early after cardiac arrest (CA). However, the potential value of elevated serum glycocalyx components remains unknown. Methods: This prospective observational study included patients who suffered CA and survived over 24 hours in the ICU of the Affiliated Hospital of Xuzhou Medical University from September 2021 to October 2022. Serum samples were collected 24 hours post CA to assess the concentration of glycocalyx shedding, including Heparan Sulfate (HS), Hyaluronic Acid (HA) and Syndecan-1 (Sdc-1). Patients were followed for 30 days or until death after CA. Outcome measures were 30-day Cerebral Performance Categories scale (CPC≤2, good function group; CPC>2, poor function group), and 30-day mortality. Logistic regression was used to assess the association of glycocalyx shedding with the 30-day CPC scale. COX regression was used to assess the association of glycocalyx shedding with 30-day mortality. Results: we included 71 patients. Compared with good function group (n=22), poor function group (n=49) had significantly higher levels of HS. Adjusted logistic regression showed that the high level of HS was associated with poor functional outcome (Figure1A, OR=0.41, 95% CI=0.21-0.79, p<0.01). Compared with the survival group (n=39), non-survival group (n=32) had higher levels of HA. Adjusted Cox regression indicated that high levels of HA was associated with mortality (Figure1B,Figure2, HA: HR=1.69,95%, CI=1.13-2.56, p<0.05). Conclusions: Elevated serum HS levels in the early stages post-CA have an association with poor functional outcomes. Increased levels of serum HA post-CA are associated with a higher 30-day mortality.