@article{3030049, title = "Stress hormones kinetics in ventricular fibrillation cardiac arrest and resuscitation: Translational and therapeutic implications", author = "Pantazopoulos, Ioannis and Boutsikos, Ioannis and Mavrovounis, Georgios and and Gkraikou, Themis and Faa, Gavino and Barouxis, Dimitrios and and Kesidou, Evangelia and Mavridis, Theodoros and Chalkias, Athanasios and and Xanthos, Theodoros", journal = "The American Journal of Emergency Medicine", year = "2021", volume = "50", pages = "14-21", publisher = "W B SAUNDERS CO-ELSEVIER INC", issn = "0735-6757", doi = "10.1016/j.ajem.2021.07.016", keywords = "Stress hormones; Resuscitation; ROSC; Ventricular fibrillation; Cardiac arrest", abstract = "Background: Knowing the kinetics of endogenous stress hormones during cardiac arrest and cardiopulmonary resuscitation (CRP) will help to optimize personalized physiology-guided treatment. The aim of this study was to examine the dynamic changes in stress hormones in a swine model of ventricular fibrillation (VF) cardiac arrest. Methods: Ventricular fibrillation was induced in 10 healthy Landrace/Large White piglets, which were subsequently left untreated for 8 min. All animals were resuscitated according to the 2015 European Resuscitation Council guidelines. The concentration of adrenalin, noradrenalin, and cortisol was measured at baseline and at the 4th and 8th minute of VF-cardiac arrest, as well as at 30-min, 60-min, 24 h and 48 h post-ROSC. Results: By the end of the 4th min of VF, the animals of the ROSC group exhibited significantly higher adrenaline levels compared to those of the no-ROSC group (7264 pg/ml vs. 1648 pg/ml. p - 0.03). Noradrenaline was higher in the ROSC group at the 4th min of VI (3021 pg/ml vs. 1626 pg/ml, p = 0.02). Cortisol levels in the ROSC group were significantly lower by the end of the 8th min of VF[16.25 ng/ml vs. 92.82 ng/ml, p 0.031. With a cut-off point of 5970 pg/ml, adrenaline at the 4th min of VF exhibited 100% sensitivity and 80% specificity for predicting ROSC. Conclusion: Higher endogenous adrenaline and lower endogenous cortisol levels were associated with ROSC. (C) 2021 Elsevier Inc. All rights reserved." }