NSE as a predictor of death or poor neurological outcome after non-shockable cardiac arrest due to any cause: Ancillary study of HYPERION trial data

Autor: Thierry Boulain, Alain Cariou, Stéphane Legriel, François Desroys du Roure, Amélie Le Gouge, Jean-Pierre Frat, Nicolas Pichon, Elisabeth Coupez, Gwenhael Colin, Jean-Pierre Quenot, Pierre-François Dequin, Arnaud-Félix Miailhe, Sylvie Vimeux, Didier Thevenin, Jean-Baptiste Lascarrou, Jean Reignier
Přispěvatelé: AfterROSC Network Group [Paris], Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours, Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier de Versailles André Mignot (CHV), Centre d'Investigation Clinique de Limoges (CIC1435), CHU Limoges-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional d'Orléans (CHRO), Université de Poitiers - Faculté de Médecine et de Pharmacie, Université de Poitiers, Funded by the District Hospital Centre, La Roche Sur Yon, France and by Laerdal Fondation, Stavenger, Norway., Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)
Rok vydání: 2020
Předmět:
medicine.medical_specialty
Resuscitation
Out-of-hospital cardiac arrest/mortality
Brain ischaemia/enzymology
Hypothermia
030204 cardiovascular system & hematology
Emergency Nursing
Multicentre study
03 medical and health sciences
0302 clinical medicine
[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system
Hypothermia
Induced
Internal medicine
medicine
Humans
In patient
Prospective Studies
Prospective cohort study
business.industry
Neurological status
Induced
Out-of-hospital cardiac arrest/complications
030208 emergency & critical care medicine
Ancillary Study
Multimodal therapy
Prognosis
3. Good health
Heart Arrest
Phosphopyruvate Hydratase
Emergency Medicine
Biomarker (medicine)
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Biomarkers/blood
Biomarkers
Out-of-Hospital Cardiac Arrest
Zdroj: Resuscitation
Resuscitation, Elsevier, 2021, 158, pp.193-200. ⟨10.1016/j.resuscitation.2020.11.035⟩
ISSN: 1873-1570
0300-9572
DOI: 10.1016/j.resuscitation.2020.11.035⟩
Popis: International audience; Purpose: Prognostication of hypoxic-ischaemic brain injury after resuscitation from cardiac arrest is based on a multimodal approach including biomarker assays. Our goal was to assess whether plasma NSE helps to predict day-90 death or poor neurological outcome in patients resuscitated from cardiac arrest in non-shockable rhythm. Methods: All included patients participated in the randomised multicentre HYPERION trial. Serum blood samples were taken 24, 48, and 72 h after randomisation; pre-treated, aliquoted, and frozen at −80 °C at the study sites; and shipped to a central biology laboratory, where the NSE assays were performed. Primary outcome was neurological status at day 90 assessed by Cerebral Performance Category (1 or 2 versus. 3, 4 or 5). Results: NSE was assayed in 235 assessable blood samples from 101 patients. In patients with good versus poor outcomes, median NSE values at 24, 48, and 72 h were 22.6 [95%CI, 14.6;27.3] ng/mL versus 33.6 [20.5;90.0] ng/mL (p < 0.04), 18.1 [11.7;29.7] ng/mL versus 76.8 [21.5;206.6] ng/mL (p < 0.0029), and 9 [6.1;18.6] ng/mL versus 80.5 [22.9;236.1] ng/mL (p < 0.001), respectively. NSE at 48 and 72 h predicted the neurological outcome with areas under the receiver-operating curve of 0.79 [95%CI, 0.69;0.96] and 0.9 [0.81;0.96], respectively. NSE levels did not differ significantly between the groups managed at 33°C and 37°C (p = 0.59). Conclusions: Data from a multicentre trial on cardiac arrest with a non-shockable rhythm due to any cause confirm that NSE values at 72 h are associated with 90-day outcome. NSE levels did not differ significantly according to the targeted temperature. Registration Identifier: ClinicalTrial NCT02722473.
Databáze: OpenAIRE
Externí odkaz: