The predictive value of neuron-specific enolase and s-100b protein for neurological outcome in patients with extracorporeal cardiopulmonary resuscitation
Objective To evaluate the prognostic value of serum levels of neuron-specific enolase(NSE)and S-100b in extracorporeal cardiopulmonary resuscitation(ECPR)patients.Methods Cardiac arrest(CA)patients whose blood samples were collected at 24 h,48 h and 72 h after establishment of extracorporeal membrane oxygenation between April 2021 and April 2024 in Emergency Department of the First Affiliated Hospital of Nanjing Medical University were enrolled in this single-center study.The serum levels of NSE and S-l00b were measured,and their peak values within 72 h were used for further analysis.The neuro-prognostic values of these two indicators in predicting poor outcomes(Cerebral Performance Category 3-5)were analyzed.Results Among the 110 patients involved,81 cases(73.6％)were poor outcomes after ECPR treatment.In the poor-outcome group,serum peak levels of NSE and S-l00b were significantly increased(P＜0.05).Furthermore,the poor-outcome group was divided into CPC 3-4 group and CPC 5 group.The levels of NSE and S-100b in CPC 5 group were significantly higher than those in CPC 1-2 and 3-4 groups(P＜0.05).NSE levels were significantly lower in CPC 1-2 group than in CPC 3-4 group(P=0.048),while no significant differences of S-l00b levels were found between the two groups(P=0.143).Multivariate logistic regression analysis showed that NSE was an independent risk factor for poor outcomes in ECPR patients(OR=1.047,95％CI:1.018～1.077,P=0.001).ROC curve showed that peak levels of NSE(AUC=0.843,95％CI:0.770～0.915,P＜0.001)and S-l00b(AUC=0.822,95％CI:0.739～0.905,P＜0.001)within 72 h had predictive value for poor outcomes in ECPR patients,with optimal cut-off values of 60.14 μg/L and 0.195 μg/L,respectively.Conclusions The serum peak levels of NSE and S-l00b within 72 h after ECMO establishment in ECPR patients are correlated with poor neurological outcomes.
万方数据
维普
