The objectives of this study were to analyze changes in serum
interleukin-8 (IL-8) and
tumor necrosis factor-alpha (
TNF-alpha) levels in patients that restored spontaneous circulation after
cardiopulmonary arrest (CPA), and to clarify the cause and significance of elevated serum
cytokines after
resuscitation. Twenty-eight patients who were admitted to our hospital after out of hospital CPA were studied. Patients'
IL-8 levels and
TNF-alpha levels in serum increased to a peak within 12 h and within 6 h after the return of spontaneous circulation (ROSC), respectively. Serum
IL-8 levels in patients who died or became
brain dead within 1 week after ROSC were significantly higher than those in other patients. In stepwise multiple regression analysis, maximum
IL-8 values were significantly correlated with maximum
TNF-alpha values within post-ROSC 24 h, with the total dose of administered
epinephrine and with peripheral neutrophil counts. It is especially noteworthy that the total dose of
epinephrine administered during and after
resuscitation markedly influenced the elevation of serum
IL-8 after ROSC. The increases in serum
IL-8 induced by excessive administration of
epinephrine might be harmful in the ROSC-patients resuscitated after CPA.