Presence of tumor necrosis factor in humans undergoing cardiopulmonary resuscitation with return of spontaneous circulation

Abstract

Tumor necrosis factor-alpha (TNF) was measured in 21 patients who presented to the emergency department in normothermic, nontraumatic cardiopulmonary arrest and who had eventual return of spontaneous circulation (ROSC). Tumor necrosis factor was measured by an enzyme-linked immunosorbent assay in serum collected at various time points after the initiation of cardiopulmonary resuscitation (CPR). Tumor necrosis factor was not detected within 4 hours post-ROSC in any patient, but was detected in all nine patients in whom survival post-ROSC was 6 hours or more. Six of nine patients demonstrated TNF presence at 6 hours. No patient demonstrating TNF at 6 hours survived longer than 27 hours post-ROSC. In patients surviving at least 12 hours, production of 400 pg/mL TNF was associated with a 100% mortality. Tumor necrosis factor is released in cardiopulmonary arrest patients who survive at least 6 hours post-ROSC and may play a role in the global ischemia-reperfusion phenomena of CPR.