Assessment of oxidative stress after out-of-hospital cardiac arrest

• Published in: The American journal of emergency medicine 2016-08, Vol.34 (8), p.1561-1566
• Main Authors: Orban, Jean-Christophe, MD, PhD, Garrel, Catherine, MD, PhD, Déroche, Didier, MD, Cattet, Florian, MD, Ferrari, Patricia, MD, Berthier, Frédéric, MD, Ichai, Carole, MD, PhD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antioxidants; Biomarkers - blood; Blood pressure; Carbonyl compounds; Cardiac arrest; Cardiopulmonary Resuscitation - methods; Catheters; Emergency; Emergency medical care; Fatalities; Female; Humans; Hypothermia; Inflammation; Laboratories; Lipid peroxidation; Lipids; Male; Measurement techniques; Middle Aged; Mortality; Out-of-Hospital Cardiac Arrest - blood; Out-of-Hospital Cardiac Arrest - therapy; Oxidation; Oxidative Stress; Prognosis; Prospective Studies; Proteins; Respiratory distress syndrome; Rodents; Studies; Young Adult
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2016.05.054

Abstract Introduction Pathophysiology of cardiac arrest corresponds to a whole body ischaemia-reperfusion. This phenomenon is usually associated with an oxidative stress in various settings but few data are available on cardiac arrest in human. The aim of the present study was to evaluate different oxidative stress markers in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia. Material and methods We conducted a prospective study assessing oxidative stress markers (TBARS, carbonyls, thiols, glutathione, glutathione peroxidase) in out of hospital cardiac arrest patients treated with therapeutic hypothermia. Measurements were performed during the 4 days after admission and compared between good and poor outcome patients according to Cerebral Performance Category. Results Thirty-four patients were included, 10 good and 24 poor outcomes at 6 months. TBARS were higher in the poor outcome group on admission and when therapeutic hypothermia was reached. The other markers were not different between groups. No markers seemed modified by the use of therapeutic hypothermia in each group. Conclusions After out-of-hospital cardiac arrest, good outcome patients exhibit lower oxidative stress markers than poor outcome patients. TBARS appears to be an early prognostic parameter. Oxidative stress markers seem not mitigated by therapeutic hypothermia.