Floerchinger, Bernhard and Philipp, Alois and Camboni, Daniele and Foltan, Maik and Lunz, Dirk and Lubnow, Matthias and Zausig, York and Schmid, Christof (2017) NSE serum levels in extracorporeal life support patients-Relevance for neurological outcome? RESUSCITATION, 121. pp. 166-171. ISSN 0300-9572,
Full text not available from this repository. (Request a copy)Abstract
Background: Good neurological outcome is a major determinant after cardiac resuscitation. Extracorporeal life support may rapidly stabilize the patient, but cerebral ischemia remains a frequent complication relevant for further therapy. The aim of this study was to prove the value of NSE to indicate cerebral injury in patients with extracorporeal support after CPR. Methods: 159 patients with CPR were included. NSE 48 h peak levels and trends were tested for usability as predictive marker of brain injury, in-hospital mortality and long-term outcome. Results: Overall mortality in this cohort was 53.5%. Incidence of relevant brain injury was 34.6% with severe diffuse hypoxia in 23.2%. NSE peaks were comparable in patients with and without focal ischemia, but were increased in patients with severe diffuse hypoxic injury (p < 0.0001). ROC analysis (area under the curve) of peak values indicating brain injury and in-hospital mortality was 0.73 (95% confidence interval [CI] 0.65-0.82) and 0.74 (95% CI 0.66-0.81), respectively. NSE increased in 56.6% of patients with a sensitivity of 0.82 (95% CI 0.69-0.92) and a specificity of 0.43 (CI 0.0.31-0.55) indicating cerebral injury. Sensitivity and specificity of NSE peak levels > 100 mu g/L was 0.6 (CI 0.49-0.72) and 0.74 (CI 0.63-0.84). In-hospital mortality of patients with NSE > 100 mu g/L was 71.7%. 46.2% of discharged patients are in good neurological status (cerebral performance category scale [CPC] 1-2). Patients with NSE < 100 mu g/L showed an in-hospital mortality of 36.4%, and good neurological status in 67.9%. Conclusion: NSE monitoring reliably indicates relevant cerebral injury in patients on extracorporeal support after cardiopulmonary resuscitation. (C) 2017 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | NEURON-SPECIFIC ENOLASE; CARDIOPULMONARY-RESUSCITATION; CARDIAC-ARREST; S-100B; INJURY; ADULTS; Cardiac arrest; eCPR; Brain injury |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:19 |
| Last Modified: | 14 Feb 2019 09:47 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1783 |
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