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Open AccessArticle

Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management

Department of Emergency Medicine, Ulsan University College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
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Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(1), 159; https://doi.org/10.3390/jcm9010159 (registering DOI)
Received: 21 November 2019 / Revised: 27 December 2019 / Accepted: 5 January 2020 / Published: 7 January 2020
(This article belongs to the Section Emergency Medicine)
This study aimed to determine the prognostic ability of serial neuron-specific enolase (NSE) and lactate in cardiac arrest survivors treated with targeted temperature management (TTM) and to investigate whether a combination of NSE and lactate could increase prognostic information. This observational, retrospective, cohort study was conducted between January 2013 and December 2018; data were extracted from an out-of-hospital cardiac arrest registry. We collected serial serum NSE and lactate levels during TTM. The primary endpoint was poor neurological outcome at 28 days from cardiac arrest. Of all 160 included patients, 98 (61.3%) had poor neurological outcomes. Areas under the curves (AUCs) for NSE were 0.797, 0.871, and 0.843 at 24, 48, and 72 h, respectively (all p < 0.05). AUCs for lactate were 0.669, 0.578, 0.634, and 0.620 at 0, 24, 48, and 72 h, respectively (all p < 0.05). Although the combination of initial lactate and NSE at 48 h yielded the highest discovered AUC (0.877) it was not statistically different from that for the 48 h NSE alone (p = 0.692). During the TTM, NSE at 48 h from cardiac arrest was the most robust prognostic marker in comatose cardiac arrest survivors. However, a combination of the 48 h NSE with lactate did not increase the prognostic information. View Full-Text
Keywords: cardiac arrest; lactic acid; neuron-specific enolase; prognosis cardiac arrest; lactic acid; neuron-specific enolase; prognosis
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Ryoo, S.M.; Kim, Y.-J.; Sohn, C.H.; Ahn, S.; Seo, D.W.; Kim, W.Y. Prognostic Abilities of Serial Neuron-Specific Enolase and Lactate and their Combination in Cardiac Arrest Survivors During Targeted Temperature Management. J. Clin. Med. 2020, 9, 159.

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