Change in the Intrathecal Cytokine level in Hypoxic-ischemic Encephalopathy after Cardiac Arrest.
- Author:
Woon Jeoung LEE
1
;
Kyu Nam PARK
;
Si Kyoung JEONG
;
Chun Song YOUN
;
Se Kyung KIM
Author Information
1. Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. emsky@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Cardiac arrest;
Cerebrospinal fluid;
Interleukin-1beta;
Interleukin-6;
Cerebral performance category;
Brain;
Ischemic-reperfusion injury
- MeSH:
Brain;
Cardiopulmonary Resuscitation;
Cerebrospinal Fluid;
Emergency Service, Hospital;
Enzyme-Linked Immunosorbent Assay;
Headache;
Heart Arrest*;
Humans;
Hypoxia-Ischemia, Brain*;
Interleukin-1beta;
Interleukin-6;
Prospective Studies
- From:Journal of the Korean Society of Emergency Medicine
2003;14(5):494-499
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was performed to evaluate the changes in the IL-1beta and the IL-6 concentrations in cerebrospinal fluid (CSF) after initial successful cardiopulmonary resuscitation (CPR), to examine the difference in the IL-1beta and the IL-6 concentrations in CSF between the cerebral performance category (CPC) 1-2 group and CPC 3-5 group after successful CPR, and to identify early makers predicting the outcome after successful CPR. METHODS: We studied prospectively 10 patients with spontaneous circulation after CPR. Samples of CSF were taken at 20 min, 4 hr, 24 hr, and 48 hr after restoration of spontaneous circulation. The control group was consisted of the nonspecific 6 patients in brain computed tomography and CSF finding among the visited patients in emergency department with complaints of headache. The CSF IL-1beta and IL-6 were measured by using enzyme-linked immunosorbent assays. RESULTS: 1) The concentrations of CSF IL-6 for CPC 3-5 were higher in the successful CPR group than in the control group. 2) In the severely neurologically disabled group (CPC 3-5), the concentrations of CSF IL-6 were significantly higher at 20 min 4 hr, 24 hr and 48 hr after successful CPR than they were in the mildly neurologically disabled group(CPC 1-2). 3) The concentrations of CSF IL-6 in the severely neurologically disabled group (CPC 3-5) reached peak levels at 24 hours after successful CPR. 4) The concentrations of CSF IL-1beta did not differ between the two groups. CONCLUSION: Our study indicates that CSF IL-6 is increased more in the severely neurologically disabled group (CPC 3-5) than it is in the mildly neurologically disabled group (CPC 1-2) after successful CPR. We found a significant relationship between the concentration of CSF IL-6 and initial outcome for the CPR patient. Thus, we suggest that CSF IL-6 might play a role in brain ischemic-reperfusion injury and might be used as a prognostic marker after successful CPR.
