Objective: To investigate whether patients after successful cardiopulmonary resuscitation (CPR) exist elevated levels of soluble P-and E-selectin (sP-selectin, sE-selectin), matrix metalloproteinases-9 (MMP-9) and to evaluate the clinical significance of changes in these cytokine levels.
Methods: Plasma levels of sP-and sE-selectin, MMP-9 of 82 patients who survived >or=48 hours after CPR were determined on the second day after successful CPR. They were classified into different groups according to whether causing systemic inflammatory response syndrome (SIRS) and developing sepsis. Sixty-five non-critically ill patients were served as control group.
Results: Incidence of SIRS was 68.3% (56/82 cases) after successful CPR. Plasma levels of sP-selectin were higher in patients with SIRS compared with those in patients without SIRS or control group (all P<0.01). Plasma levels of sE-selectin and MMP-9 were not significantly different between patients with SIRS and without SIRS (all P>0.05), but were higher in both patient groups than those in the control group (all P<0.01) 43.9% of the patients developed sepsis within 1 week after CPR. Plasma levels of sP-selectin were higher in patients developing sepsis than those in patients without sepsis (P<0.05), but plasma levels of sE-selectin and MMP-9 were not significantly different between two groups (all P>0.05). Plasma levels of sE-selectin and MMP-9 were higher in nonsurvivors than those in survivors (both P<0.01), but plasma levels of sP-selectin were not significantly different between two groups (all P>0.05).
Conclusion: SIRS is a frequent but unspecific finding after CPR with only minor impact on outcome. Determination of sP-and sE-selectin, MMP-9 early after CPR might help to identify patients at a high risk for sepsis or an adverse, respectively.