Copeptin levels are associated with organ dysfunction and death in the intensive care unit after out-of-hospital cardiac arrest

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Ristagno , G , Latini , R , Plebani , M , Zaninotto , M , Vaahersalo , J , Masson , S , Tiainen , M , Kurola , J , Gaspari , F , Milani , V , Pettila , V , Skrifvars , M B & FINNRESUSCI Study Grp 2015 , ' Copeptin levels are associated with organ dysfunction and death in the intensive care unit after out-of-hospital cardiac arrest ' Critical Care , vol. 19 , 132 . DOI: 10.1186/s13054-015-0831-y

Title: Copeptin levels are associated with organ dysfunction and death in the intensive care unit after out-of-hospital cardiac arrest
Author: Ristagno, Giuseppe; Latini, Roberto; Plebani, Mario; Zaninotto, Martina; Vaahersalo, Jukka; Masson, Serge; Tiainen, Marjaana; Kurola, Jouni; Gaspari, Flavio; Milani, Valentina; Pettila, Ville; Skrifvars, Markus Benedikt; FINNRESUSCI Study Grp
Contributor: University of Helsinki, Neurologian yksikkö
University of Helsinki, Department of Diagnostics and Therapeutics
University of Helsinki, Department of Diagnostics and Therapeutics
Date: 2015-03-31
Language: eng
Number of pages: 8
Belongs to series: Critical Care
ISSN: 1466-609X
URI: http://hdl.handle.net/10138/212202
Abstract: Introduction: We studied associations of the stress hormones copeptin and cortisol with outcome and organ dysfunction after out-of-hospital cardiac arrest (OHCA). Methods: Plasma was obtained after consent from next of kin in the FINNRESUSCI study conducted in 21 Finnish intensive care units (ICUs) between 2010 and 2011. We measured plasma copeptin (pmol/L) and free cortisol (nmol/L) on ICU admission (245 patients) and at 48 hours (additional 33 patients). Organ dysfunction was categorised with 24-hour Sequential Organ Failure Assessment (SOFA) scores. Twelve-month neurological outcome (available in 276 patients) was classified with cerebral performance categories (CPC) and dichotomised into good (CPC 1 or 2) or poor (CPC 3 to 5). Data are presented as medians and interquartile ranges (IQRs). A Mann-Whitney U test, multiple linear and logistic regression tests with odds ratios (ORs) 95% confidence intervals (CIs) and beta (B) values, repeated measure analysis of variance, and receiver operating characteristic curves with area under the curve (AUC) were performed. Results: Patients with a poor 12-month outcome had higher levels of admission copeptin (89, IQR 41 to 193 versus 51, IQR 29 to 111 pmol/L, P = 0.0014) and cortisol (728, IQR 522 to 1,017 versus 576, IQR 355 to 850 nmol/L, P = 0.0013). Copeptin levels fell between admission and 48 hours (P Conclusions: Admission copeptin and free cortisol were not of prognostic value regarding 12-month neurological outcome after OHCA. Higher admission copeptin and cortisol were associated with ICU death, and copeptin predicted subsequent organ dysfunction.
Subject: ACUTE MYOCARDIAL-INFARCTION
HEART-FAILURE
THERAPEUTIC HYPOTHERMIA
SPONTANEOUS CIRCULATION
PROGNOSTIC MARKER
RESUSCITATION
INSUFFICIENCY
PROANP
STROKE
RETURN
3126 Surgery, anesthesiology, intensive care, radiology
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