Author/Editor		Grmec, Štefek; Strnad, Matej; Kupnik, Dejan; Sinkovič, Andreja; Gazmuri, Raúl J.
Title		Erythropoietin facilitates the return of spontaneous circulation and survival in victims of out-of-hospital cardiac arrest
Type		članek
Vol. and No.		Letnik 80, št. 6
Publication year		2009
Volume		str. 631-637
ISSN		0300-9572 - Resuscitation
Language		eng
Abstract		Background: Erythropoietin activates potent protective mechanisms in non-hematopoietic tissues including the myocardium. In a rat model of ventricular fibrillation, erythropoietin preserved myocardial compliance enabling hemodynamically more effective CPR. Objective: To investigate whether intravenous erythropoietin given within 2 min of physician-led CPR improves outcome from out-of-hospital cardiac arrest. Methods: Erythropoietin (90,000IU of beta-epoetin, n=24) was compared prospectively with 0.9 % NaCl (concurrent controls=30) and retrospectively with a preceding group treated with similar protocol (matched controls=48). Results: Compared with concurrent controls, the erythropoietin group had higher rates of ICU admission(92 % vs 50 %, p=0.004), return of spontaneous circulation (ROSC) (92 % vs 53 %, p=0.006), 24-h survival (83 % vs 47 %, p=0.008), and hospital survival (54 % vs 20 %, p=0.011). However, after adjusting for pretreatment covariates only ICU admission and ROSC remained statistically significant. Compared with matched controls, the erythropoietin group had higher rates of ICU admission (92 % vs 65 %, p=0.024) and 24-h survival (83 % vs 52 %, p=0.014) with statistically insignificant higher ROSC (92% vs 71 %, p=0.060) and hospital survival (54 % vs 31 %, p=0.063). However, after adjusting for pretreatment covariates all four outcomes were statistically significant. End-tidal PCO(2) (an estimate of blood flow during chest compression) was higher in the erythropoietin group. Conclusions: Erythropoietin given during CPR facilitates ROSC, ICU admission, 24-h survival, and hospital survival. This effect was consistent with myocardial protection leading to hemodynamically more effective CPR (Trial registration: http://isrctn.org. Identifier: ISRCTN67856342).
Descriptors		Heart Arrest Srčni zastoj Cardiopulmonary Resuscitation Kardiopulmonalno oživljanje Erythropoietin Eritropoietin Myocardium Miokardij Ischemia Ishemija Emergency Treatment Nujno ukrepanje Treatment Outcome Izid zdravljenja Survival Preživetje