Predicting outcome in patients under extracorporeal membrane oxygenation due to cardiogenic shock through dynamic change of lymphocytes and interleukins
Journal
IJC Metabolic and Endocrine
Journal Volume
7
Date Issued
2015-06-01
Author(s)
Hong, Tsai Hsia
Hu, Fu Chang
Ko, Wen Je
Abstract
Objectives: Peripheral blood parameters implicating the irreversible damages of cardiogenic shock under extracorporeal membrane oxygenation (ECMO) support patients were investigated. Methods: The blood was collected from 23 cardiogenic shock cases at the time of ECMO installation, and 2, 6, 12, and 24. h after oxygenation. Plasma levels of IL-2, IL-6, IL-7, IL-8, IL-10, IFN-γ, MCP-1, and carbonic anhydrase IX (CA IX) were determined by ELISA. Reactive oxygen species were measured by luminol and lucigenin and leukocyte subpopulations were analyzed by flow cytometry. Generalized additive models (GAMs) were performed to identify the death ranges of every variable and the variables were further discretized at each time point. The combination of predictors was selected from both original and discretized covariates by the generalized linear model (GLM) at each time point. Results: Plasma IL-10 level was the most distinct biomarker between survivors and non-survivors after oxygenation. IL-10 sequentially partnered with IL-6, IL-7, and lymphocyte percentage at 2h, with CD3+CD4+ T cells at 6h, with CA IX at 12h, and CD3+ T lymphocytes at 24h predicted death with AUCs 1.000, 0.975, 0.992, and 0.992, respectively. Conclusions: Combination of the GAM plots and GLM models overcame the complexity of different disease categories. The systemic irreversible damages from cardiogenic shock ECMO cases might be detected from several peripheral blood parameters.
Subjects
Carbonic anhydrase IX | Cardiogenic shock | CD4 T cells | ECMO | IL-10 | Lymphocytes
Carbonic anhydrase IX; Cardiogenic shock; CD4 T cells; ECMO; IL-10; Lymphocytes
SDGs
Other Subjects
carbonate dehydratase IX; cytokine; gamma interferon; interleukin 10; interleukin 2; interleukin 6; interleukin 7; interleukin 8; lucigenin; luminol; monocyte chemotactic protein 1; reactive oxygen metabolite; acute heart infarction; adult; aorta dissection; Article; cardiogenic shock; CD3+ T lymphocyte; CD4+ T lymphocyte; clinical article; congestive cardiomyopathy; enzyme linked immunosorbent assay; extracorporeal oxygenation; female; flow cytometry; heart arrhythmia; human; lymphocyte; male; myocarditis; outcome assessment; priority journal; survival
Type
journal article