Ability of neuron-specific enolase to predict survival to hospital discharge after successful cardiopulmonary resuscitation
| Autor: | Robert Berent, Herbert Mayr, Elisabeth Lassnig, Porodko M, Christian Punzengruber, Maurer E, Johann Auer, Bernd Eber, Gudrun Lamm, Thomas Weber |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors medicine.medical_treatment Enolase Return of spontaneous circulation Sensitivity and Specificity Predictive Value of Tests Hospital discharge medicine Humans In patient Cardiopulmonary resuscitation Aged Aged 80 and over business.industry Middle Aged Prognosis Cardiopulmonary Resuscitation Patient Discharge Confidence interval Heart Arrest Surgery ROC Curve Austria Phosphopyruvate Hydratase Anesthesia Predictive value of tests Time course Emergency Medicine Female business Biomarkers |
| Zdroj: | CJEM. 8:13-18 |
| ISSN: | 1481-8043 1481-8035 |
| Popis: | Background: Accurate prediction of survival to hospital discharge in patients who achieve return of spontaneous circulation after cardiopulmonary resuscitation (CPR) has significant ethical and socioeconomic implications. We investigated the prognostic performance of serum neuron-specific enolase (NSE), a biochemical marker of ischemic brain injury, after successful CPR. Methods: In-hospital or out-of-hospital patients with nontraumatic normothermic cardiac arrest who achieved return of spontaneous circulation (ROSC) following at least 5 minutes of CPR were eligible. Neuron-specific enolase levels were assessed immediately, 6 hours, 12 hours and 2 days after ROSC. Subjects were followed to death or hospital discharge. Results: Seventeen patients (7 men, 10 women) were enrolled during a 1-year period. Median (range) NSE levels in survivors and non-survivors respectively were as follows: immediately after ROSC: 14.0 μg/L (9.1–51.4 μg/L) versus 25.9 μg/L (10.2–57.5 μg/L); 6 hours after ROSC: 15.2 μg/L (9.7–30.8 μg/L) versus 25.6 μg/L (12.7–38.2 μg/L); 12 hours after ROSC: 14.0 μg/L (8.6–32.4 μg/L) versus 28.5 μg/L (11.0–50.7 μg/L); and 48 hours after ROSC: 13.1 μg/L (7.8–29.5 μg/L) versus 52.0 μg/L (29.1–254.0 μg/L). Non-survivors had significantly higher NSE levels 48 hours after ROSC than surivors (p = 0.04) and showed a trend toward higher values during the entire time course following ROSC. An NSE concentration of >30 μg/L 48 hours after ROSC predicted death with a high specificity (100%: 95% confidence interval [CI] 85%–100%), and a level of 29 μg/L or less at 48 hours predicted survival with a high specificity (100%: 95% CI 83%–100%). Conclusions: Serum NSE levels may have clinical utility for the prediction of survival to hospital discharge in patients after ROSC following CPR over 5 minutes in duration. This study is small, and our results are limited by wide confidence intervals. Further research on ability of NSE to facilitate prediction and clinical decision-making after cardiac arrest is warranted. |
| Databáze: | OpenAIRE |
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