title: PLASMA HEME OXYGENASE-1 IN PATIENTS RESUSCITATED FROM OUT-OF-HOSPITAL CARDIAC ARREST.
abstract: Heme oxygenase-1 (HO-1) is an enzyme induced by hypoxia and reperfusion injury, and is associated with organ dysfunction in critically ill patients. Patients resuscitated from out-of-hospital cardiac arrest (OHCA) are subjected to hypoxemia, brain injury, and organ dysfunction. Accordingly, we studied HO-1 among these patients. A total of 143 OHCA patients resuscitated from a shockable initial rhythm and admitted to an ICU were included, with plasma HO-1 measured at ICU admission and at 24 h. We analyzed the associations between plasma HO-1 and time to return of spontaneous circulation (ROSC), 90-day mortality, and 12-month Cerebral Performance Category (CPC). HO-1 plasma concentrations were higher after OHCA compared with controls. HO-1 concentrations at admission and on day 1 associated with ROSC (P = 0.002 to P = 0.003). Admission and day 1 HO-1 plasma concentrations were higher in 90-day non-survivors than in survivors (P = 0.017, 0.026). In addition, poor neurological outcome (CPC 3-5) was associated with higher HO-1 plasma levels at admission (P = 0.024). Admission plasma HO-1 levels had an AUC of 0.623 to predict 90-day mortality and an AUC of 0.611 to predict CPC 3 to 5. In conclusion, we found that higher HO-1 plasma levels are associated with longer ROSC and poor long-term outcome.
authors.affiliation: *Minerva Foundation Institute for Medical Research †Division of Intensive Care Medicine, Department of Perioperative, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland ‡Intensivmedizin, Bern University Hospital §Department of Neurology ||Abdominal Center, Nephrology ¶Clinical Chemistry and Hematology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Juuso
authors.initials: J
authors.lastname: Siren
authors.forename: Jukka
authors.initials: J
authors.lastname: Vaahersalo
authors.forename: Markus
authors.initials: M
authors.lastname: Skrifvars
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.forename: Marjaana
authors.initials: M
authors.lastname: Tiainen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Tikkanen
authors.forename: Päivi
authors.initials: P
authors.lastname: Lakkisto
mesh_terms: D001930:Brain Injuries / Q000097:blood / Q000209:etiology / Q000401:mortality; D018572:Disease-Free Survival; D051547:Heme Oxygenase-1 / Q000097:blood*; D000860:Hypoxia / Q000097:blood / Q000209:etiology / Q000401:mortality / Q000628:therapy; D009102:Multiple Organ Failure / Q000097:blood / Q000209:etiology / Q000401:mortality; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood* / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D012151:Resuscitation; D015996:Survival Rate; D013997:Time Factors
chemical_list: C496541:HMOX1 protein, human; D051547:Heme Oxygenase-1