• Annals of intensive care · Aug 2017

    Lymphopaenia in cardiac arrest patients.

    • Paola Villois, David Grimaldi, Savino Spadaro, Shinotsuka Claudia Righy CR Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium., Vito Fontana, Sabino Scolletta, Federico Franchi, Jean-Louis Vincent, Jacques Creteur, and Fabio Silvio Taccone.
    • Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.
    • Ann Intensive Care. 2017 Aug 14; 7 (1): 85.

    BackgroundA decrease in circulating lymphocytes has been described as a marker of poor prognosis after septic shock; however, scarce data are available after cardiac arrest (CA). The aim of this study was to evaluate the impact of lymphopaenia after successful cardiopulmonary resuscitation.MethodsThis is a retrospective analysis of an institutional database including all adult CA patients admitted to the intensive care unit (ICU) between January 2007 and December 2014 who survived for at least 24 h. Demographic, CA-related data and ICU mortality were recorded as was lymphocyte count on admission and for the first 48 h. A cerebral performance category score of 3-5 at 3 months was considered as an unfavourable neurological outcome.ResultsData from 377 patients were analysed (median age: 62 [IQRs: 52-75] years). Median time to return of spontaneous circulation (ROSC) was 15 [8-25] min and 232 (62%) had a non-shockable initial rhythm. ICU mortality was 58% (n = 217) and 246 (65%) patients had an unfavourable outcome at 3 months. The median lymphocyte count on admission was 1208 [700-2350]/mm3 and 151 (40%) patients had lymphopaenia (lymphocyte count <1000/mm3). Predictors of lymphopaenia on admission were older age, a shorter time to ROSC, prior use of corticosteroid therapy and high C-reactive protein levels on admission. ICU non-survivors had lower lymphocyte counts on admission than survivors (1100 [613-2317] vs. 1316 [891-2395]/mm3; p = 0.05) as did patients with unfavourable compared to those with favourable neurological outcomes (1100 [600-2013] vs. 1350 [919-2614]/mm3; p = 0.003). However, lymphopaenia on admission was not an independent predictor of poor outcomes in the entire population, but only among OHCA patients.ConclusionsA low lymphocyte count is common in CA survivors and is associated with poor outcome after OHCA.

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