prognostic value of cell-free plasma dna in patients with cardiac arrest outside the hospital an observational cohort study预后价值的心脏骤停患者的血浆游离dna在医院外一个观察性队列研究.pdfVIP

Arnalich et al. Critical Care 2010, 14:R47 /content/14/2/R47 R E S E A R C H Open Access Research Prognostic value of cell-free plasma DNA in patients with cardiac arrest outside the hospital: an observational cohort study 1 1 2 1 1 3 Francisco Arnalich* , Marta Menéndez , Verónica Lagos , Enrique Ciria , Angustias Quesada , Rosa Codoceo , 1 4 2 Juan José Vazquez , Eduardo López-Collazo and Carmen Montiel Abstract Introduction: Many approaches have been examined to try to predict patient outcome after cardiopulmonary resuscitation. It has been shown that plasma DNA could predict mortality in critically ill patients but no data are available regarding its clinical value in patients after out-of-hospital cardiac arrest. In this study we investigated whether plasma DNA on arrival at the emergency room may be useful in predicting the outcome of these patients. Methods: We performed a prospective study of out-of-hospital patients with cardiac arrest who achieved return of spontaneous circulation after successful resuscitation. Cardiovascular co-morbidities and resuscitation history were recorded according to the Utstein Style. The outcome measures were 24 h and overall in-hospital mortality. Cell-free plasma DNA was measured by real-time quantitative PCR assay for the β-globin gene in blood samples drawn within two hours after the arrest. Descriptive statistics, multiple logistic regression analysis, and receiver operator characteristic (ROC) curves were calculated. Results: Eighty-five consecutive patients were analyzed with a median time to return of spontaneous circulation of 27 minutes (interquartile range