Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest
| العنوان: | Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest |
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| المؤلفون: | Gisela Lilja, Johan Undén, Janneke Horn, Sofia Backman, Christian Hassager, Josef Dankiewicz, Hans Friberg, Henrik Zetterberg, Niklas Nielsen, Pascal Stammet, Niklas Mattsson-Carlgren, Christian Rylander, Tobias Cronberg, Jesper Kjaergaard, Susann Ullén, Matt P. Wise, Erik Westhall, Marion Moseby-Knappe, Kaj Blennow |
| المساهمون: | Intensive Care Medicine, ANS - Neuroinfection & -inflammation |
| المصدر: | Intensive Care Medicine Moseby-Knappe, M, Mattsson-Carlgren, N, Stammet, P, Backman, S, Blennow, K, Dankiewicz, J, Friberg, H, Hassager, C, Horn, J, Kjaergaard, J, Lilja, G, Rylander, C, Ullén, S, Undén, J, Westhall, E, Wise, M P, Zetterberg, H, Nielsen, N & Cronberg, T 2021, ' Serum markers of brain injury can predict good neurological outcome after out-of-hospital cardiac arrest ', Intensive Care Medicine, vol. 47, pp. 984–994 . https://doi.org/10.1007/s00134-021-06481-4Test Intensive care medicine, 47(9), 984-994. Springer Verlag |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, Neurofilament light, Neurology, Glial fibrillary acidic protein, biology, business.industry, Original, Enolase, ERC/ESICM guidelines, Guideline, Prognostication, Critical Care and Intensive Care Medicine, Cardiac arrest, Outcome (game theory), Blood biomarkers, Good neurological outcome, Internal medicine, Anesthesiology, medicine, biology.protein, business, Pathological |
| الوصف: | Purpose The majority of unconscious patients after cardiac arrest (CA) do not fulfill guideline criteria for a likely poor outcome, their prognosis is considered “indeterminate”. We compared brain injury markers in blood for prediction of good outcome and for identifying false positive predictions of poor outcome as recommended by guidelines. Methods Retrospective analysis of prospectively collected serum samples at 24, 48 and 72 h post arrest within the Target Temperature Management after out-of-hospital cardiac arrest (TTM)-trial. Clinically available markers neuron-specific enolase (NSE) and S100B, and novel markers neurofilament light chain (NFL), total tau, ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) and glial fibrillary acidic protein (GFAP) were analysed. Normal levels with a priori cutoffs specified by reference laboratories or defined from literature were used to predict good outcome (no to moderate disability, Cerebral Performance Category scale 1–2) at 6 months. Results Seven hundred and seventeen patients were included. Normal NFL, tau and GFAP had the highest sensitivities (97.2–98% of poor outcome patients had abnormal serum levels) and NPV (normal levels predicted good outcome in 87–95% of patients). Normal S100B and NSE predicted good outcome with NPV 76–82.2%. Normal NSE correctly identified 67/190 (35.3%) patients with good outcome among those classified as “indeterminate outcome” by guidelines. Five patients with single pathological prognostic findings despite normal biomarkers had good outcome. Conclusion Low levels of brain injury markers in blood are associated with good neurological outcome after CA. Incorporating biomarkers into neuroprognostication may help prevent premature withdrawal of life-sustaining therapy. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-021-06481-4. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 0342-4642 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::efcb6556acc7380dab0a3595ead2b5c1Test https://doi.org/10.1007/s00134-021-06481-4Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....efcb6556acc7380dab0a3595ead2b5c1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 03424642 |
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