Secretoneurin as a marker for hypoxic brain injury after cardiopulmonary resuscitation
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Secretoneurin as a marker for hypoxic brain injury after cardiopulmonary resuscitation. / Hasslacher, Julia; Lehner, Georg Franz; Harler, Ulrich; Beer, Ronny; Ulmer, Hanno; Kirchmair, Rudolf; Fischer-Colbrie, Reiner; Bellmann, Romuald; Dunzendorfer, Stefan; Joannidis, Michael.
In: INTENS CARE MED, Vol. 40, No. 10, 10.2014, p. 1518-27.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Secretoneurin as a marker for hypoxic brain injury after cardiopulmonary resuscitation
AU - Hasslacher, Julia
AU - Lehner, Georg Franz
AU - Harler, Ulrich
AU - Beer, Ronny
AU - Ulmer, Hanno
AU - Kirchmair, Rudolf
AU - Fischer-Colbrie, Reiner
AU - Bellmann, Romuald
AU - Dunzendorfer, Stefan
AU - Joannidis, Michael
PY - 2014/10
Y1 - 2014/10
N2 - PURPOSE: The neuropeptide secretoneurin (SN) shows widespread distribution in the brain. We evaluated whether SN is elevated after cardiopulmonary resuscitation (CPR) and could serve as a potential new biomarker for hypoxic brain injury after CPR.METHODS: This was a prospective observational clinical study. All patients admitted to a tertiary medical intensive care unit after successful CPR with expected survival of at least 24 h were consecutively enrolled from September 2008 to April 2013. Serum SN and neuron-specific enolase were determined in 24 h intervals starting with the day of CPR for 7 days. Neurological outcome was assessed with the Cerebral Performance Categories Scale (CPC) at hospital discharge.RESULTS: A total of 134 patients were included with 49 % surviving to good neurological outcome (CPC 1-2). SN serum levels peaked within the first 24 h showing on average a sixfold increase above normal. SN levels were significantly higher in patients with poor (CPC 3-5) than in patients with good neurological outcome [0-24 h: 75 (43-111) vs. 38 (23-68) fmol/ml, p < 0.001; 24-48 h: 45 (24-77) vs. 23 (16-39) fmol/ml, p < 0.001]. SN determined within the first 48 h showed a receiver operating characteristic (ROC) area under the curve (AUC) of 0.753 (0.665-0.841). NSE in the first 72 h had a ROC-AUC of 0.881 (0.815-0.946). When combining the two biomarkers an AUC of 0.925 (0.878-0.972) for outcome prediction could be reached.CONCLUSIONS: SN is a promising early biomarker for hypoxic brain injury. Further studies will be required for confirmation of these results.
AB - PURPOSE: The neuropeptide secretoneurin (SN) shows widespread distribution in the brain. We evaluated whether SN is elevated after cardiopulmonary resuscitation (CPR) and could serve as a potential new biomarker for hypoxic brain injury after CPR.METHODS: This was a prospective observational clinical study. All patients admitted to a tertiary medical intensive care unit after successful CPR with expected survival of at least 24 h were consecutively enrolled from September 2008 to April 2013. Serum SN and neuron-specific enolase were determined in 24 h intervals starting with the day of CPR for 7 days. Neurological outcome was assessed with the Cerebral Performance Categories Scale (CPC) at hospital discharge.RESULTS: A total of 134 patients were included with 49 % surviving to good neurological outcome (CPC 1-2). SN serum levels peaked within the first 24 h showing on average a sixfold increase above normal. SN levels were significantly higher in patients with poor (CPC 3-5) than in patients with good neurological outcome [0-24 h: 75 (43-111) vs. 38 (23-68) fmol/ml, p < 0.001; 24-48 h: 45 (24-77) vs. 23 (16-39) fmol/ml, p < 0.001]. SN determined within the first 48 h showed a receiver operating characteristic (ROC) area under the curve (AUC) of 0.753 (0.665-0.841). NSE in the first 72 h had a ROC-AUC of 0.881 (0.815-0.946). When combining the two biomarkers an AUC of 0.925 (0.878-0.972) for outcome prediction could be reached.CONCLUSIONS: SN is a promising early biomarker for hypoxic brain injury. Further studies will be required for confirmation of these results.
KW - APACHE
KW - Aged
KW - Area Under Curve
KW - Biomarkers
KW - Cardiopulmonary Resuscitation
KW - Diagnostic Techniques, Neurological
KW - Female
KW - Heart Arrest
KW - Humans
KW - Hypoxia, Brain
KW - Intensive Care Units
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Neuropeptides
KW - Organ Dysfunction Scores
KW - Out-of-Hospital Cardiac Arrest
KW - Phosphopyruvate Hydratase
KW - Predictive Value of Tests
KW - Prospective Studies
KW - ROC Curve
KW - Secretogranin II
KW - Tertiary Care Centers
KW - Time-to-Treatment
KW - Journal Article
U2 - 10.1007/s00134-014-3423-4
DO - 10.1007/s00134-014-3423-4
M3 - SCORING: Journal article
C2 - 25138227
VL - 40
SP - 1518
EP - 1527
JO - INTENS CARE MED
JF - INTENS CARE MED
SN - 0342-4642
IS - 10
ER -
