%0 Journal Article
%T Serial measurement of neuron specific enolase improves prognostication in cardiac arrest patients treated with hypothermia: A prospective study
%A Christian Storm
%A Jens Nee
%A Achim J£¿rres
%A Christoph Leithner
%A Dietrich Hasper
%A Christoph J Ploner
%J Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
%D 2012
%I BioMed Central
%R 10.1186/1757-7241-20-6
%X In a prospective study of 35 patients resuscitated from cardiac arrest, NSE was measured daily for four days following admission. Outcome was assessed at ICU discharge using the CPC score. All patients received hypothermia treatment for 24 hours at 33¡ãC with a surface cooling device according to current guidelines.The cutoff for absolute NSE levels in patients with unfavourable outcome (CPC 3-5) 72 hours after cardiac arrest was 57 ¦Ìg/l with an area under the curve (AUC) of 0.82 (sensitivity 47%, specificity 100%). The cutoff level for NSE kinetics in patients with unfavourable outcome (CPC 3-5) was an absolute increase of 7.9 ¦Ìg/l (AUC 0.78, sensitivity 63%, specificity 100%) and a relative increase of 33.1% (AUC 0.803, sensitivity 67%, specificity 100%) at 48 hours compared to admission.In cardiac arrest patients treated with hypothermia, prognostication of unfavourable outcome by NSE kinetics between admission and 48 hours after resuscitation may be superior to prognostication by absolute NSE levels.The recommended examinations proposed by the American Academy of Neurology (AAN) for prognostication in patients after cardiac arrest have mainly been evaluated in the era prior to hypothermia [1]. However, recent studies indicate that mild therapeutic hypothermia modifies the prognostic significance of clinical findings, NSE levels, and electrophysiological testing in patients resuscitated from cardiac arrest [2-6]. This has generated the necessity to re-evaluate all prognostic markers in patients treated with hypothermia. In particular, NSE cutoff levels and their temporal dynamics have only rarely been investigated in these patients so far. In this study, we prospectively investigated serum NSE levels and NSE kinetics in 35 cardiac arrest patients treated with hypothermia.The study protocol was approved by the local ethics committee on human research and was conducted in accordance with the guidelines of the Declaration of Helsinki. Written informed consent to the
%K NSE
%K kinetic
%K prognostication
%K cardiac arrest
%K hypothermia
%U http://www.sjtrem.com/content/20/1/6