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Brain injury marker...
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Lagebrant, AliceLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
(author)
Brain injury markers in blood associate with generalised oedema on computed tomography after cardiac arrest
- Article/chapterEnglish2021
Publisher, publication year, extent ...
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2021-09-29
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Springer Science and Business Media LLC,2021
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2 s.
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LIBRIS-ID:oai:lup.lub.lu.se:8327a74a-0926-428a-9686-65dc36991272
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https://lup.lub.lu.se/record/8327a74a-0926-428a-9686-65dc36991272URI
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https://doi.org/10.1186/s40635-021-00413-8DOI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:kon swepub-publicationtype
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Subject category:ref swepub-contenttype
Notes
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Introduction. According to the 2021 ERC/ESICM guideline recommen-dations, elevated neuron-specific enolase [NSE] levels as well as diffuseand extensive anoxic damage on neuroimaging are predictors of poorneurological outcome after cardiac arrest.(1) We previously describedthat NSE is elevated in patients with generalised oedema on com-puted tomography [CT]. (2).Objectives. In this study, we aim to examine the novel brain injurymarkers serum neurofilament light [NFL], glial fibrillary acidic protein[GFAP] and total-tau [tau] to predict the presence of generalised brainoedema.Methods. Retrospective analysis of patients examined with CT onclinical indication within the Target Temperature Management afterout-of-hospital cardiac arrest [TTM] trial. (2,3) Serum samples fromthe biobank sub study were prospectively collected at 48 h post arrestand analysed after trial completion as published. (4–7) The neuronalmarker NSE, the neuroaxonal injury markers NFL and tau and theastrocytic injury marker GFAP were correlated with the presence ofgeneralised oedema on CT, assessed by local radiologists through vis-ual evaluation. The prognostic accuracy of NSE ≥ 60 ug/l for predictinggeneralised oedema was also analysed.Results. 192 patients had data available on all four biomarkers at 48 hand were examined with CT < 168 h post arrest. Brain injury markerswere significantly higher in patients with generalised oedema as com-pared to patients without oedema on CT scans performed 24–168 hafter ROSC (p < 0.001) (Fig. 1A–D). For CT scans performed < 24 h, onlyNSE levels showed a significant correlation (p < 0.05). Biomarkers pre -dicted generalised oedema with area under the receiver operatingcharacteristics curve [AUC] 67.5–73.2% for CT scans performed < 24 h(n = 111), with no statistically significant difference between themarkers ( Fig. 2A). For scans performed 24–168 h (n = 81) AUC for pre -dicting generalised oedema was 78.1%-82.9%, with no statisticallysignificant difference between the markers. NSE ≥ 60 ug/l at 48 h, asrecommended by guidelines, predicted generalised oedema with 81%(95%CI 67–90%) sensitivity and 77% (95%CI 62–87%) specificity.Conclusion. Concentrations of all evaluated brain injury markerswere significantly higher in patients with generalised oedema on CTperformed after the first 24 h post arrest. Biomarker concentrationsindicate whether generalised oedema on CT is likely and may thus beclinically useful for deciding if a CT scan is sufficient for prognostica-tion or if a MRI is more appropriate.
Subject headings and genre
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Lang, M.Lund University
(author)
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Mattsson-Carlgren, NiklasLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-nmn
(author)
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Blennow, K.University of Gothenburg
(author)
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Dankiewicz, JosefLund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-jfd
(author)
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Friberg, HansLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)efor-hfr
(author)
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Christian, HCopenhagen University Hospital
(author)
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Horn, J.Academic Medical Center of University of Amsterdam (AMC)
(author)
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Kjaergaard, JCopenhagen University Hospital
(author)
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Kuiper, MichaelMedical Center Leeuwarden
(author)
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Lilja, GiselaLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-gal
(author)
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Pellis, TAzienda Sanitaria Friuli Occidentale
(author)
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Rylander, ChristianSahlgrenska University Hospital
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Siemund, RogerLund University,Lunds universitet,Neuroradiologi,Forskargrupper vid Lunds universitet,Neuroradiology,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-rrs
(author)
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Undén, JohanLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)neur-jun
(author)
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Wise, MatthewUniversity Hospital of Wales
(author)
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Zetterberg, H.University of Gothenburg
(author)
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Cronberg, TobiasLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine(Swepub:lu)efor-tcr
(author)
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Moseby-Knappe, MarionLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital(Swepub:lu)med-mmy
(author)
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Stammet, PascalNational Fire and Rescue Corps
(author)
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Neurologi, LundSektion IV
(creator_code:org_t)
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Lagebrant, Alice
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Blennow, K.
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Friberg, Hans
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Christian, H
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Horn, J.
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Kjaergaard, J
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Kuiper, Michael
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Lilja, Gisela
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Pellis, T
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Rylander, Christ ...
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Siemund, Roger
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Undén, Johan
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Wise, Matthew
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