{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T19:10:22Z","timestamp":1776280222951,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Achieving an acceptable neurological outcome in cardiac arrest survivors remains challenging. Ischemia\u2010reperfusion injury induces inflammation, which may cause secondary neurological damage. We studied the association of ICU admission levels of inflammatory biomarkers with disturbed 48\u2010hour continuous electroencephalogram (cEEG), and the association of the daily levels of these markers up to 72\u2009h with poor 6\u2010month neurological outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is an observational, post hoc sub\u2010study of the COMACARE trial. We measured serum concentrations of procalcitonin (PCT), high\u2010sensitivity C\u2010reactive protein (hsCRP), osteopontin (OPN), myeloperoxidase (MPO), resistin, and proprotein convertase subtilisin\/kexin type 9 (PCSK9) in 112 unconscious, mechanically ventilated ICU\u2010treated adult OHCA survivors with initial shockable rhythm. We used grading of 48\u2010hour cEEG monitoring as a measure for the severity of the early neurological disturbance. We defined 6\u2010month cerebral performance category (CPC) 1\u20132 as good and CPC 3\u20135 as poor long\u2010term neurological outcome. We compared the prognostic value of biomarkers for 6\u2010month neurological outcome to neurofilament light (NFL) measured at 48\u2009h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Higher OPN (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.03), MPO (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), and resistin (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.01) concentrations at ICU admission were associated with poor grade 48\u2010hour cEEG. Higher levels of ICU admission OPN (OR 3.18; 95% CI 1.25\u20138.11 per ln[ng\/ml]) and MPO (OR 2.34; 95% CI 1.30\u20134.21) were independently associated with poor 48\u2010hour cEEG in a multivariable logistic regression model. Poor 6\u2010month neurological outcome was more common in the poor cEEG group (63% vs. 19% <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001, respectively). We found a significant fixed effect of poor 6\u2010month neurological outcome on concentrations of PCT (F\u00a0=\u00a07.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01), hsCRP (F\u00a0=\u00a04.0, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), and OPN (F\u00a0=\u00a05.6, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) measured daily from ICU admission to 72\u2009h. However, the biomarkers did not have independent predictive value for poor 6\u2010month outcome in a multivariable logistic regression model with 48\u2010hour NFL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated ICU admission levels of OPN and MPO predicted disturbances in cEEG during the subsequent 48\u2009h after cardiac arrest. Thus, they may provide early information about the risk of secondary neurological damage. However, the studied inflammatory markers had little value for long\u2010term prognostication compared to 48\u2010hour NFL.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.14145","type":"journal-article","created":{"date-parts":[[2022,8,27]],"date-time":"2022-08-27T10:08:12Z","timestamp":1661594892000},"page":"94-103","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Markers of neutrophil mediated inflammation associate with disturbed continuous electroencephalogram after out of hospital cardiac arrest"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-3409","authenticated-orcid":false,"given":"Pirkka T.","family":"Pekkarinen","sequence":"first","affiliation":[{"name":"Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Carbone","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IRCCS Ospedale Policlinico San Martino Genoa\u2013Italian Cardiovascular Network  Genoa Italy"},{"name":"First Clinic of Internal Medicine, Department of Internal Medicine University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Minetti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IRCCS Ospedale Policlinico San Martino Genoa\u2013Italian Cardiovascular Network  Genoa Italy"},{"name":"First Clinic of Internal Medicine, Department of Internal Medicine University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Ramoni","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine IRCCS Ospedale Policlinico San Martino Genoa\u2013Italian Cardiovascular Network  Genoa Italy"},{"name":"First Clinic of Internal Medicine, Department of Internal Medicine University of Genoa  Genoa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Ristagno","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation University of Milan  Milan Italy"},{"name":"Department of Anesthesiology, Intensive Care and Emergency Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Latini","sequence":"additional","affiliation":[{"name":"Cardiovascular Medicine Mario Negri Institute for Pharmacological Research IRCCS  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauri","family":"Wihersaari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Kuopio University Hospital and University of Eastern Finland  Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaj","family":"Blennow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg  M\u00f6lndal Sweden"},{"name":"Clinical Neurochemistry Laboratory Sahlgrenska University Hospital  M\u00f6lndal Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg  M\u00f6lndal Sweden"},{"name":"Clinical Neurochemistry Laboratory Sahlgrenska University Hospital  M\u00f6lndal Sweden"},{"name":"Department of Neurodegenerative Disease UCL Institute of Neurology, Queen Square  London UK"},{"name":"UK Dementia Research Institute at UCL  London UK"},{"name":"Hong Kong Center for Neurodegenerative Diseases  Hong Kong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jussi","family":"Toppila","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurophysiology, Medical Imaging Center, Helsinki University Central Hospital and Department of Clinical Neurosciences (Neurophysiology) University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pekka","family":"Jakkula","sequence":"additional","affiliation":[{"name":"Division of Intensive Care, Department of Anaesthesiology, Intensive Care and Pain Medicine University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6878-3740","authenticated-orcid":false,"given":"Matti","family":"Reinikainen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Kuopio University 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