Elevated glycocalyx shedding components as the early predictors of unfavorable outcomes in patients after cardiac arrest: A single-center observational study.

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of critical care Pub Date : 2025-01-24 DOI:10.1016/j.jcrc.2025.155026

Dan He, Shuqun Hu, Ningjun Zhao, Xianliang Yan, Chenglei Su

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引用次数: 0

Abstract

Objective: To assess the association of serum glycocalyx shedding components (Heparan sulfate, HS; Hyaluronic acid, HA; Syndecan-1, Sdc-1) with outcomes after CA.

Methods: Patients who were comatose for >24 h after CA in the intensive care unit (ICU) of the Affiliated Hospital of Xuzhou Medical University from 9/2021 to 04/2023 were enrolled. Serum samples were collected 24 h after CA to measure the concentrations of glycocalyx shedding components. The outcomes were the 30-day Cerebral Performance Categories (CPC) scale and 30-day mortality. The association of glycocalyx shedding with outcomes was examined by regression analysis. The area under the curve was used to evaluate the value of glycocalyx shedding for predicting outcomes. Sensitivity analysis and subgroup analysis were conducted.

Results: 111 patients were enrolled. The unfavorable group (CPC 3-5, n = 69) had significantly higher serum concentrations of HA and Sdc-1 than the favorable group (CPC 1-2, n = 42) (HA:149.7 ng/ml vs. 824.8 ng/ml, P < 0.001; Sdc-1: 303.8 ng/L vs. 447.0 ng/L, P = 0.026)but not HS. Elevated serum HA concentrations was an independent risk factor for unfavorable 30-day neurological function (OR = 2.485, 95 % CI = 1.656-3.729). For the 30-day mortality, the nonsurvivor group (n = 53) had significantly higher serum concentrations of HA, HS and Sdc-1 (HA: 177.3 ng/ml vs. 1106.7 ng/ml, P < 0.001; HS: 2403.7 ng/ml vs. 3383.3 ng/ml P = 0.030; Sdc-1: 352.1 ng/L vs. 487.8 ng/L, P = 0.005) than the survivor group (n = 58). However, only elevated serum HA and Sdc-1 concentrations are independent risk factors for 30-day mortality (HA: HR = 2.321, 95 % CI = 1.776-3.035; Sdc-1: HR = 1.702, 95 % CI = 1.038-2.792).

Conclusions: Elevated serum HA at 24 h after CA is an independent risk factor for 30-day unfavorable neurological function or mortality and elevated serum Sdc-1 concentrations is an independent risk factor for 30-day mortality. Our results suggested the potential value of serum glycocalyx shedding components as predictors for the outcomes in post-CA patients.

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来源期刊

Journal of critical care 医学-危重病医学

CiteScore

8.60

自引率

2.70%

发文量

237

审稿时长

23 days

期刊介绍： The Journal of Critical Care, the official publication of the World Federation of Societies of Intensive and Critical Care Medicine (WFSICCM), is a leading international, peer-reviewed journal providing original research, review articles, tutorials, and invited articles for physicians and allied health professionals involved in treating the critically ill. The Journal aims to improve patient care by furthering understanding of health systems research and its integration into clinical practice. The Journal will include articles which discuss: All aspects of health services research in critical care System based practice in anesthesiology, perioperative and critical care medicine The interface between anesthesiology, critical care medicine and pain Integrating intraoperative management in preparation for postoperative critical care management and recovery Optimizing patient management, i.e., exploring the interface between evidence-based principles or clinical insight into management and care of complex patients The team approach in the OR and ICU System-based research Medical ethics Technology in medicine Seminars discussing current, state of the art, and sometimes controversial topics in anesthesiology, critical care medicine, and professional education Residency Education.