Medicina intensiva · 2026
Neuron-specific enolase in hypoxic-ischemic encephalopathy after cardiac arrest: Evaluation as a prognostic biomarker and determination of threshold values.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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López Hernández Nayara, Sánchez Cámara Silvia, Moreno Flores María Alba, Mateos Llosa Marta, Manso Murcia Clara, Herrero Gutiérrez Eugenio, de Gea García José Higinio
Аннотация
OBJECTIVE: To evaluate the prognostic value of neuron-specific enolase (NSE) in patients who suffered a cardiac arrest and to determine the threshold values at 48 and 72 h that help identify patients with a poor neurological outcome.
DESIGN: A retrospective, observational and analytical study conducted from 2021 to 2024.
SETTING: Intensive Care Unit (ICU) of Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain).
PATIENTS OR PARTICIPANTS: Eighty-one patients over 18 years of age who were admitted after resuscitated cardiac arrest and who survived for at least 72 h.
INTERVENTIONS: Patients received post-cardiac arrest care in accordance with clinical guidelines, including physical examination and complementary tests to establish the neurological prognosis using a multimodal approach.
MAIN VARIABLES OF INTEREST: Demographic data, medical history, event characteristics, clinical course, results of prognostic tests and neurological outcomes at ICU discharge and six months post-cardiac arrest were analyzed.
RESULTS: NSE levels were significantly higher in patients with poor neurological outcomes at six months (143.5 vs 23 ng/mL at 48 h y 180.5 vs 20 ng/mL at 72 h). At 48 h, a threshold of ≥55 ng/mL predicted poor outcome with 88.5% sensitivity and 100% specificity. At 72 h, a value of ≥82 ng/mL showed 100% specificity and 80.8% sensitivity.
CONCLUSIONS: NSE is a strong predictor of six-month neurological outcome. Threshold values of 55 ng/mL at 48 h and 82 ng/mL at 72 h could be useful when evaluating patients with hypoxic-ischemic encephalopathy.
DESIGN: A retrospective, observational and analytical study conducted from 2021 to 2024.
SETTING: Intensive Care Unit (ICU) of Virgen de la Arrixaca University Clinical Hospital (Murcia, Spain).
PATIENTS OR PARTICIPANTS: Eighty-one patients over 18 years of age who were admitted after resuscitated cardiac arrest and who survived for at least 72 h.
INTERVENTIONS: Patients received post-cardiac arrest care in accordance with clinical guidelines, including physical examination and complementary tests to establish the neurological prognosis using a multimodal approach.
MAIN VARIABLES OF INTEREST: Demographic data, medical history, event characteristics, clinical course, results of prognostic tests and neurological outcomes at ICU discharge and six months post-cardiac arrest were analyzed.
RESULTS: NSE levels were significantly higher in patients with poor neurological outcomes at six months (143.5 vs 23 ng/mL at 48 h y 180.5 vs 20 ng/mL at 72 h). At 48 h, a threshold of ≥55 ng/mL predicted poor outcome with 88.5% sensitivity and 100% specificity. At 72 h, a value of ≥82 ng/mL showed 100% specificity and 80.8% sensitivity.
CONCLUSIONS: NSE is a strong predictor of six-month neurological outcome. Threshold values of 55 ng/mL at 48 h and 82 ng/mL at 72 h could be useful when evaluating patients with hypoxic-ischemic encephalopathy.