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Resuscitation. 2011 Jan;82(1):26-31. doi: 10.1016/j.resuscitation.2010.10.011. Epub 2010 Nov 10.

S-100B is superior to NSE, BDNF and GFAP in predicting outcome of resuscitation from cardiac arrest with hypothermia treatment.

Author information

1
Department of Surgical Sciences, Anaesthesia and Intensive Care, Uppsala University, Uppsala University Hospital, Uppsala, Sweden. erik.mortberg@surgsci.uu.se

Abstract

OBJECTIVE:

To conduct a pilot study to evaluate the blood levels of brain derived neurotrophic factor (BDNF), glial fibrillary acidic protein (GFAP), neuron specific enolase (NSE) and S-100B as prognostic markers for neurological outcome 6 months after hypothermia treatment following resuscitation from cardiac arrest.

DESIGN:

Prospective observational study.

SETTING:

One intensive care unit at Uppsala University Hospital.

PATIENTS:

Thirty-one unconscious patients resuscitated after cardiac arrest.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Unconscious patients after cardiac arrest with restoration of spontaneous circulation (ROSC) were treated with mild hypothermia to 32-34°C for 26h. Time from cardiac arrest to target temperature was measured. Blood samples were collected at intervals of 1-108h after ROSC. Neurological outcome was assessed with Glasgow-Pittsburgh cerebral performance category (CPC) scale at discharge from intensive care and again 6 months later, when 15/31 patients were alive, of whom 14 had a good outcome (CPC 1-2). Among the predictive biomarkers, S-100B at 24h after ROSC was the best, predicting poor outcome (CPC 3-5) with a sensitivity of 87% and a specificity of 100%. NSE at 96h after ROSC predicted poor outcome, with sensitivity of 57% and specificity of 93%. BDNF and GFAP levels did not predict outcome. The time from cardiac arrest to target temperature was shorter for those with poor outcome.

CONCLUSIONS:

The blood concentration of S-100B at 24h after ROSC is highly predictive of outcome in patients treated with mild hypothermia after cardiac arrest.

[Indexed for MEDLINE]

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