• Wolfgang Sipos, Catharina Duvigneau, Fritz Sterz, Wolfgang Weihs, Danica Krizanac, Keywan Bayegan, Alexandra Graf, Romana Hartl, Andreas Janata, Michael Holzer, and Wilhelm Behringer.
• Clinical Department for Farm Animals, University of Veterinary Medicine Vienna, Austria.
• Resuscitation. 2010 May 1; 81 (5): 603-8.

Aim Of The StudyThis study aimed at evaluating (I) the impact of different intra-arrest hypothermia levels on the expression of selected cytokines and (II) their prognostic value for 9-day survival.MethodsFemale Large White pigs (n=21, 31-38 kg) were subjected to 15 min of ventricular fibrillation, followed by intra-arrest cardiopulmonary bypass cooling for 1, 3, or 5 min achieving brain temperatures (Tbr) of 30.4+/-1.6, 24.2+/-4.6 and 18.8+/-4.0 degrees C. After 40 min of controlled rewarming, pigs were defibrillated and kept at Tbr of 34.5 degrees C for 20 h, survival was for 9 days. Plasma samples were analysed for interleukin (IL)-6, tumor necrosis factor-alpha (TNF-alpha), and IL-10 levels by ELISA. Total RNA out of peripheral blood mononuclear cells was analysed by real-time PCR for IL-1, IL-2, IL-4, IL-10, TNF-alpha, interferon-gamma, inducible NO synthase, and heme oxygenase-1 gene expressions.ResultsPlasma IL-6 and TNF-alpha levels significantly (p=0.0001 and 0.0003) increased in all animals within 1h after resuscitation with no significant differences between groups. Pigs surviving exhibited a decrease in IL-10 expression between baseline and intra-arrest values as compared to non-surviving animals, which showed a slight increase (p=0.0078). ROC curve analysis revealed that changes in IL-10 expression had a good prognostic power for survival to day 9 (area under the curve=0.882).ConclusionThe systemic inflammatory response syndrome after cardiac arrest was reflected by a remarkable increase of plasma IL-6 and TNF-alpha levels. Intra-arrest hypothermia levels did not influence the expression of selected cytokines. As prognostic marker for survival IL-10 was identified with decreasing mRNA levels during cardiac arrest in survivors.Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

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