Ichikawa Yumi, Sawada Yusuke, Nakajima Jun, Isshiki Yuta, Fukushima Kazunori, Aramaki Yuto, Oshima Kiyohiro
Department of Emergency Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-Machi, Maebashi, Gunma 371-8511, Japan.
Emerg Med Int. 2021 Jul 29;2021:5324038. doi: 10.1155/2021/5324038. eCollection 2021.
The dynamic state of epinephrine (Ep) in the plasma of patients with out-of-hospital cardiac arrest (OHCA) remains unclear. The purpose of this study was to evaluate the relationship between the plasma levels of catecholamines (such as epinephrine (Ep), norepinephrine (Nep), and dopamine) and vasopressin (antidiuretic hormone (ADH)) and the acquisition of return of spontaneous circulation (ROSC) in OHCA patients.
This was a prospective, observational clinical study. Patients with OHCA transferred to our hospital between July 2014 and July 2017 were enrolled. The levels of catecholamines and ADH in the plasma were measured using blood samples immediately obtained on arrival at our hospital and before the administration of Ep. Patients in whom Ep was already administered prior to obtaining blood samples were excluded. Patients were divided into two groups: with and without ROSC, that is, ROSC (+) and ROSC (-) groups, respectively. The plasma levels of these agents and the conditions of resuscitation were compared between the two groups.
A total of 96 patients with OHCA were analyzed. The ROSC (+) and ROSC (-) groups included 34 and 62 patients, respectively. There were no significant differences observed between the two groups in age, cause of cardiopulmonary arrest, and prehospital resuscitation time. The plasma levels of Ep and Nep were significantly lower in the ROSC (+) group than in the ROSC (-) group. However, there were no significant differences in the plasma levels of dopamine and ADH between the two groups.
Increased levels of Ep in the plasma may not be associated with the acquisition of ROSC in patients with OHCA.
院外心脏骤停（OHCA）患者血浆中肾上腺素（Ep）的动态变化尚不清楚。本研究旨在评估儿茶酚胺（如肾上腺素（Ep）、去甲肾上腺素（Nep）和多巴胺）及血管加压素（抗利尿激素（ADH））的血浆水平与OHCA患者自主循环恢复（ROSC）情况之间的关系。
这是一项前瞻性观察性临床研究。纳入2014年7月至2017年7月间转至我院的OHCA患者。使用患者到达我院后立即采集且在给予Ep之前的血样测量血浆中儿茶酚胺和ADH的水平。排除在采集血样前已给予Ep的患者。患者分为两组：有ROSC组和无ROSC组，即ROSC（+）组和ROSC（-）组。比较两组这些物质的血浆水平及复苏情况。
共分析了96例OHCA患者。ROSC（+）组和ROSC（-）组分别有34例和62例患者。两组在年龄、心肺骤停原因及院前复苏时间方面未观察到显著差异。ROSC（+）组的Ep和Nep血浆水平显著低于ROSC（-）组。然而，两组间多巴胺和ADH的血浆水平无显著差异。
OHCA患者血浆中Ep水平升高可能与获得ROSC无关。
