tailieunhanh - Báo cáo y học: " Prognostic value of cell-free plasma DNA in patients with cardiac arrest outside the hospital: an observational cohort study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Prognostic value of cell-free plasma DNA in patients with cardiac arrest outside the hospital: an observational cohort study. | Arnalich et al. Critical Care 2010 14 R47 http content 14 2 R47 c CRITICAL CARE RESEARCH Open Access Prognostic value of cell-free plasma DNA in patients with cardiac arrest outside the hospital an observational cohort study Francisco Arnalich 1 Marta Menendez1 Veronica Lagos2 Enrique Ciria1 Angustias Quesada1 Rosa Codoceo3 Juan José Vazquez1 Eduardo López-Collazo4 and Carmen Montiel2 Abstract Introduction Many approaches have been examined to try to predict patient outcome after cardiopulmonary resuscitation. It has been shown that plasma DNA could predict mortality in critically ill patients but no data are available regarding its clinical value in patients after out-of-hospital cardiac arrest. In this study we investigated whether plasma DNA on arrival at the emergency room may be useful in predicting the outcome of these patients. Methods We performed a prospective study of out-of-hospital patients with cardiac arrest who achieved return of spontaneous circulation after successful resuscitation. Cardiovascular co-morbidities and resuscitation history were recorded according to the Utstein Style. The outcome measures were 24 h and overall in-hospital mortality. Cell-free plasma DNA was measured by real-time quantitative PCR assay for the p-globin gene in blood samples drawn within two hours after the arrest. Descriptive statistics multiple logistic regression analysis and receiver operator characteristic ROC curves were calculated. Results Eighty-five consecutive patients were analyzed with a median time to return of spontaneous circulation of 27 minutes interquartile range IQR 18 to 35 . Thirty patients died within 24 h and 58 died during the hospital course. Plasma DNA concentrations at admission were higher in non-survivors at 24 h than in survivors median 5 520 genome equivalents GE ml vs 2810 GE ml P and were also higher in patients who died in the hospital than in survivors to discharge median 4 150 GE ml vs 2 460 GE ml P . Lactate .