Abstract 284: The Relation Between Serum Procalcitonin and Perfusion Parameters After the Return of Spontaneous Circulation Following Out-of-Hospital Cardiac Arrest

Abstract

<Introduction>Procalcitonin (PCT) has been broadly used as an infectious biomarker. However we often found that the patients without infection showed high level of PCT. In past research, PCT has been reported to be a useful biomarker in predicting neurological outcome after the return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (OHCA). <Hypothesis>Our hypothesis is that the level of PCT in the patients after ROSC following OHCA may relate to time from cardiac arrest and reflect tissue hypoxia. Moreover it may predict outcome. This study was aimed to evaluate relation between the serum level of PCT and perfusion parameters in OHCA patients. <Methods>Twenty sequential patients who admitted to the ICU after ROSC following OHCA were included. Infectious patients, trauma patients and extracorporeal CPR patients were excluded. This study was a retrospective, single-center analysis, conducted in the ICU of the university hospital. We evaluated the maximum PCT level within 48hr after admission, cardio-pulmonary arrest time, serum lactate level at admission, Glasgow outcome scale at 28 day. <Results>Twelve of twenty patients were cardiogenic patients. Average ROSC time from OHCA was 27±17 minutes. The maximum PCT was significantly higher in patients who died in the hospital (2.2±2.6 V.S 15.3±17 ng/mL, p=0.01). We defined Glasgow outcome scale 4-5 as favorable outcomes and eight patients showed favorable outcomes. Serum PCT in patients with favorable outcomes was lower than that of unfavorable outcomes, but there was no statistical significance (1.2±2.5 V.S 9.4±13.5 ng/mL). The maximum PCT significantly correlated with serum lactate at admission (r=0.63, p<0.01), and ROSC time from OHCA (r=0.54, p=0.01). <Conclusions>In conclusion, the maximum PCT after cardiac arrest did not predict neurological outcome. But PCT correlated with degree of tissue hypoxia. The serum PCT may reflect ischemia-reperfusion injury.