Neuron-specific enolase and S-100b in prolonged targeted temperature management after cardiac arrest: A randomised study. (January 2018)

• Record Type: Journal Article
• Authors: Duez, Christophe Henri Valdemar; Grejs, Anders Morten; Jeppesen, Anni Nørgaard; Schrøder, Anne Dilani; Søreide, Eldar; Nielsen, Jørgen Feldbæk; Kirkegaard, Hans
• Is Part Of: Resuscitation. Volume 122(2018)
• Page Start: 79
• Page End: 86
• Publication Date: 2018-01
• Subjects: Neuron-specific enolase -- S-100b -- Prognostication -- Prolonged targeted temperature management -- Cardiac arrest -- Therapeutic hypothermia; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2017.11.052
• Languages: English
• ISSNs: 0300-9572

Abstract

Highlights: Serum levels of NSE and S100b are unaffected by prolonged targeted management compared to standard duration TTM. Biomarker levels at day 1, 2 and 3 after cardiac arrest and daily changes of NSE until day 2 were the best predictors of neurological outcome. The biomarkers NSE and S-100b remain reliable prognosticators, even in the case of prolonged TTM after cardiac arrest. Abstract: Background: We aimed to investigate the impact of prolonged targeted temperature management (TTM) in cardiac arrest patients on release of serum levels of NSE and S-100b and their prognostic performances. Methods: This is a substudy of the Targeted Temperature Management for 24 vs 48 h trial. NSE and S-100b levels were analysed retrospectively in serum samples collected upon admission, at 24, 48, and 72 h after reaching the target temperature of 33 ± 1 °C. The primary outcome was biomarker serum concentrations and secondary outcome was the cerebral performance category score after 6 months. Results: 115 patients from two centres were analysed. NSE and S-100b levels did not differ between TTM groups at any single time-point. Poor outcome patients had higher biomarker levels at 24, 48, and 72 h: NSE: 9.73 (7.2; 10.9) versus 20.40 (12.7; 27.2), 8.86 (6.6; 9.6) versus 17.47 (11.1; 37.3) and 6.23 (5.3; 8.5) versus 31.05 (12.8; 52.5) respectively and S-100b: 0.09 (0.07; 0.11) versus 0.23 (0.19; 0.39), 0.08 (0.07; 0.09) versus 0.18 (0.15; 0.33) and 0.07 (0.06; 0.08) versus 0.13 (0.09; 0.23). The daily changes in NSE from admission to Day 2 after the cardiac arrest (CA) were also related to the outcome (p = 0.003 and p = 0.02). The best prediction of outcome was found at 72 h for NSE and at 24 h as well as 48 h for S100b. Conclusions: No clinically relevant differences were found in the levels of NSE or S-100b between standard and prolonged TTM. Prognostic reliability of NSE and S-100b was unaltered by prolonged TTM.