Serial soluble neurofilament heavy chain in plasma as a marker of brain injury after cardiac arrest

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Rundgren, MalinLund 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 (author)

Serial soluble neurofilament heavy chain in plasma as a marker of brain injury after cardiac arrest

Article/chapterEnglish2012

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Springer Science and Business Media LLC,2012
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LIBRIS-ID:oai:lup.lub.lu.se:691f54bb-aa2b-4afe-aa98-74d5de476e44
https://lup.lub.lu.se/record/3504132URI
https://doi.org/10.1186/cc11244DOI

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Language:English
Summary in:English

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Introduction: Induced hypothermia has been shown to improve outcome after cardiac arrest, but early prognostication is hampered by the need for sedation. Here we tested whether a biomarker for neurodegeneration, the neurofilament heavy chain (NfH), may improve diagnostic accuracy in the first days after cardiac arrest. Methods: This prospective study included 90 consecutive patients treated with hypothermia after cardiac arrest. Plasma levels of phosphorylated NfH (SMI35) were quantified using standard ELISA over a period of 72 h after cardiac arrest. The primary outcome was the dichotomized Cerebral Performance Categories scale (CPC). A best CPC 1-2 during 6 months follow-up was considered a good outcome, a best CPC of 3-4 a poor outcome. Receiver operator characteristics and area under the curve were calculated. Results: The median age of the patients was 65 years, and 63 (70%) were male. A cardiac aetiology was identified in 62 cases (69%). 77 patients (86%) had out-of-hospital cardiac arrest. The outcome was good in 48 and poor in 42 patients. Plasma NfH levels were significantly higher 2 and 36 hours after cardiac arrest in patients with poor outcome (median 0.28 ng/mL and 0.5 ng/mL, respectively) compared to those with good outcome (0 ng/mL, p = 0.016, p < 0.005, respectively). The respective AUC were 0.72 and 0.71. Conclusions: Plasma NfH levels correlate to neurological prognosis following cardiac arrest. In this study, 15 patients had neurological co-morbidities and there was a considerable overlap of data. As such, neurofilament should not be used for routine neuroprognostication until more data are available.

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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)
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)
Romner, Bertil (author)
Petzold, Axel (author)
Anestesiologi och intensivvårdSektion II (creator_code:org_t)

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In:Critical Care: Springer Science and Business Media LLC16:21364-8535

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By the author/editor: Rundgren, Malin; Friberg, Hans; Cronberg, Tobias; Romner, Bertil; Petzold, Axel

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

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