Serum neuron-specific enolase predicts outcome in post-anoxic coma: a prospective cohort study.

Autor:	Meynaar, Iwan A., Straaten, Heleen M. Oudemans-van, Wetering, Jacobus, Verlooy, Peter, Slaats, Ed H., Bosman, Rob J., Spoel, Johan I., Zandstra, Durk F., Oudemans-van Straaten, Heleen M, van der Wetering, Jacobus, van der Spoel, Johan I
Předmět:	SERUM RESUSCITATION BLOOD plasma CARDIOPULMONARY system ELECTROPHYSIOLOGY CRITICAL care medicine MEDICAL personnel BRAIN death CARDIAC arrest CEREBRAL anoxia COMA COMPARATIVE studies CONSCIOUSNESS CARDIOPULMONARY resuscitation ENZYMES LONGITUDINAL method RESEARCH methodology MEDICAL cooperation MULTIVARIATE analysis PROGNOSIS RESEARCH SOMATOSENSORY evoked potentials TIME LOGISTIC regression analysis EVALUATION research TREATMENT effectiveness PREDICTIVE tests BLIND experiment HOSPITAL mortality GLASGOW Coma Scale DISEASE complications THERAPEUTICS
Zdroj:	Intensive Care Medicine; Feb2003, Vol. 29 Issue 2, p189-195, 7p
Abstrakt:	Objective: The aim of this study was to investigate whether serial serum neuron-specific enolase (NSE) can be used to predict neurological prognosis in patients remaining comatose after cardiopulmonary resuscitation (CPR). DESIGN. Observational cohort study. Clinicians were blinded to NSE results.Setting: Eighteen-bed general ICU.Patients: Comatose patients admitted to the ICU after CPR.Interventions: Serum NSE was measured at admission and daily for 5 days.Measurements and Results: Patients received full intensive treatment until recovery or until absence of cortical response to somatosensory evoked potentials more than 48 h after CPR proved irreversible coma. Of the 110 patients included (mean GCS at ICU admission 3, range 3--9), 34 regained consciousness, five of whom died in hospital. Seventy-six patients did not regain consciousness, 72 of whom died in hospital. Serum NSE at 24 h and at 48 h after CPR was significantly higher in patients who did not regain consciousness than in patients who regained consciousness (at 24 h: median NSE 29.9 microg/l, range 1.8-250 vs 9.9 microg/l, range 4.5-21.5, P<0.001; at 48 h: median 37.8 microg/l, range 4.4-411 vs 9.5 microg/l, range 6.2-22.4, P= 0.001). No patient with a serum NSE level >25.0 microg/l at any time regained consciousness. Addition of NSE to GCS and somatosensory evoked potentials increased predictability of poor neurological outcome from 64% to 76%.Conclusions: High serum NSE levels in comatose patients at 24 h and 48 h after CPR predict a poor neurological outcome. Addition of NSE to GCS and somatosensory evoked potentials increases predictability of neurological outcome. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
Externí odkaz:	Zobrazit plný text záznamu Full text from SpringerLink