Objectives: There are many studies that evaluate the effect of hydrocortisone and vasopressin during advanced life support (ALS) in out-of-hospital cardiac arrest (OHCA) with heterogeneous causes, but results remain controversial. We investigated hormone levels during ALS according to the specific cause of arrest in OHCA patients.

Methods: This study is a single-center retrospective analysis of prospectively registered data of OHCA patients from June 2016 to December 2017. All CPR data were registered according to the Utstein-style guidelines. Blood samples were taken early during ALS and levels of cortisol, adrenocorticotropic hormone (ACTH), and antidiuretic hormone (ADH) were measured. We examined the correlation between each hormone level and outcome of patients, and analyzed the relationship between each hormone level and each specific cause of arrest.

Results: Overall, 250 OHCA patients were included in the final analysis. There was no significant association between cortisol levels and patient outcomes, but cortisol levels were significantly higher in patients with sepsis. In contrast, cortisol levels were significantly lower in patients with trauma. ACTH levels were significantly higher in patients with sepsis, acute coronary syndrome, and good neurological outcome. Even though ADH level was not significantly associated with outcome, and were reported as the upper limit of the measurement range in most patients, patients with sepsis and acute coronary syndrome as cause of arrest had significantly lower ADH levels.

Conclusion: Cortisol, ACTH, and ADH levels during ALS in OHCA patients are different between etiologies of arrest. Even though cortisol and ADH levels are not associated to patient outcomes, high ACTH levels in OHCA is associated with good neurological outcome.

6 - Hormone levels during cardiopulmonary resuscitation in out-of-hospital cardiac arrest