Concentration of hormones regulating water and electrolytes balance in patients after cardiac arrest

Background and goals

The aim of the study was the assessment of the level of hormones playing main biological functions in the regulation of water and electrolyte balance in patents after cardiac arrest (CA).

Materials

Forty-five patients (patients) were divided into two groups. Group I, 22 patients after CA, 17 men and five women, age 64 ± 13 years. CA was caused by ventricular fibrillation in 14 cases and by asystolia in eight. In 16 patients CA appeared in acute coronary syndrome. Fifty percent of patients died during hospital treatment. Group II, 23 patients, aged 60 ± 11 years, 20 men and three women, with stable coronary artery disease.

Methods

In group I vein blood samples were taken just after CA and on two consecutive days at 8:00 am. In these patients we assessed the concentrations of hormones: adrenocortycotropic hormone (ACTH), cortisol (Cort), renin, aldosterone (Aldo), vasopressin (AVP) and N-terminated natriuretic propeptyde type B (NT-pBNP). In patients of group II, concentrations of the aforementioned hormones were assessed once from a blood sample taken at 8:00 am. Results were analyzed by statistical methods.

Results

Data (mean ± SD) are presented in Table 1. In patients after CA who died in hospital, compared with patients after CA who survived, a markable higher concentration of Cort and Renin and lower ACTH and AVP were found.

Table 1

Conclusions

(1) There is strong activation of hormonal mechanisms regulating the water-electrolyte balance and controlling blood pressure in patients after CA. (2) A high concentration of cortisol with a concomitant improper increase of ACTH suggests bad resolution in patients after CA.