Neuron specific enolase and S-100B as predictors of outcome after cardiac arrest and induced hypothermia |
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Authors: | Malin Rundgren,Torbjö rn Karlsson,Niklas Nielsen,Tobias Cronberg,Per Johnsson,Hans Friberg |
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Affiliation: | 1. Department of Anaesthesia and Intensive Care, Lund University Hospital, S-221 85 Lund, Sweden;2. Department of Anaesthesia, University Hospital of Malmö, Malmö, Sweden;3. Department of Anaesthesia, Helsingborg Hospital, Helsingborg, Sweden;4. Department of Neurology, Lund University Hospital, Lund, Sweden;5. Department of Cardiothoracic Surgery, Lund University Hospital, Lund, Sweden;6. Department of Anaesthesia and Intensive Care, Lund University Hospital, Lund, Sweden |
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Abstract: | ![]()
AimTo assess the prognostic value of repetitive serum samples of neuron specific enolase (NSE) and S-100B in cardiac arrest patients treated with hypothermia.MethodsIn a three-centre study, comatose patients after cardiac arrest were treated with hypothermia at 33 °C for 24 h, regardless of cause or the initial rhythm. Serum samples were collected at 2, 24, 48 and 72 h after the arrest and analysed for NSE and S-100B in a non-blinded way. The cerebral performance categories scale (CPC) was used as the outcome measure; a best CPC of 1–2 during 6 months was regarded as a good outcome, a best CPC of 3–5 a poor outcome.ResultsOne centre was omitted in the NSE analysis due to missing 24 and 48 h samples. Two partially overlapping groups were studied, the NSE group (n = 102) and the S-100B group (n = 107). NSE at 48 h >28 μg/l (specificity 100%, sensitivity 67%) and S-100B >0.51 μg/l at 24 h (specificity 96%, sensitivity 62%) correlated with a poor outcome, and so did a rise in NSE of >2 μg/l between 24 and 48 h (odds ratio 9.8, CI 3.5–27.7). A majority of missing samples (n = 123) were from the 2 h sampling time (n = 56) due to referral from other hospitals or inter-hospital transfer.ConclusionNSE was a better marker than S-100B for predicting outcome after cardiac arrest and induced hypothermia. NSE above 28 μg/l at 48 h and a rise in NSE of more than 2 μg/l between 24 and 48 h were markers for a poor outcome. |
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Keywords: | Cardiac arrest Hypothermia NSE S-100B Outcome |
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