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8/8/2019 REX AND CLIFTON
http://slidepdf.com/reader/full/rex-and-clifton 2/11
Alexandra Schratter; Holger Thiele; Katharina Demmin; Denise Lehmann; Meinhard Mende; Gerhard
Schuler; Thorsten Klemm; Undine Pittl
Univ Leipzig, Leipzig, Germany; Cntr for Clinical Studies, Leipzig, Germany; Univ Leipzig, Leipzig,
Germany; Laboratory Reising-Ackermann, Leipzig,
Germany; Univ Leipzig, Leipzig, Germany
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Purpose: NSE (neuron specific enolase) is a well-known
blood parameter for quantifying neuronal damage andtherefore predicting neurologic outcome after cardiac
arrest. However, recent studies showed discrepant results
regarding specific time-points of blood sample acquisition
and cut-off values of NSE in order to obtain optimalpredictive power. We conducted this study by collecting
blood samples from patients undergoing therapeutic
hypothermia after cardiac arrest in order to define new
cut-off values of NSE as well as the time-point of its most predictive power regarding good neurologic outcome.
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Methods: Blood samples were collected from patients
undergoing therapeutic hypothermia after cardiac arrest
either by invasive or external cooling at 7 pre-definedtime-points (0, 6, 12, 24, 36, 48 and 72 hours) before and
after the onset of hypothermic treatment. One hundred-
and-nine patients were included in the study. Neurologic
outcome was assessed at hospital discharge (cerebralperformance category, CPC). ROC-curves of NSE values
were drawn for all time-points in order to determine cut-
off values for good neurologic outcome (CPC 1 and 2).
Cut-off values of NSE at each time-point were determinedby taking the value with the highest sensitivity still showing
100% specificity.
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Results: Area under the curve of all ROC-curvesincreased from time-point to time-point and reached its
maximum at 72 hours, which indicates best predictive
power regarding good neurologicoutcome. Our
determined NSE cut-off values were 42.5, 41.0, 43.5,35.5, 36.5, 46.5 and 29.0 ng/mL for time-points 0, 6, 12,
24, 36, 48 and 72 hours, respectively. Patients with good
neurologic outcome all showed a NSE value below the
determinedcut-off for every time-point.
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Conclusions: Neuron specific enolase is a well-known
predictor for neurologic outcome after cardiac arrest and
cardiopulmonary resuscitation. By including a large
number of patients, we could determine a new reliable
NSE cut-off value. NSE < 29 ng/mL at 72 hours after the
onset of therapeutic hypothermia has the strongest
predictive power for good neurologic outcome.
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Author Disclosures: A. Schratter: None. H. Thiele:None. K. Demmin: None. D. Lehmann: None.M.
Mende: None. G. Schuler: None. T. Klemm: None. U.
Pittl: None.
http://circ.ahajournals.org/cgi/content/meeting_abstract/1
22/21_MeetingAbstracts/A129?maxtoshow=&hits=10&R
ESULTFOR M AT=&fulltext=neurologic+researches&sear
chid=1&FIRSTINDEX=0&resourcetype=HWCIT
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REACTION:This study was conducted to determine at
what specific period we can predict the most
accurate neurologic outcome after a cardiac
arrest and undergoing hypothermic treatment.They have found out that a new reliable NSE cut-
off value is <29ng/mL at 72 hours after onset of
therapy has the strongeast predictive power for
good neurologic outcome.
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This finding is very helpful because it
improves the use of NSE as a parameter and
also treatment among these patients.And also, it may increase survival rate among
cardiac arrest if this new finding could lessen
cardiac arrest episodes among patients risk for
cardiac arrest.
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SUBMITTED BY:
GUINODEN, REX DAVE T.AYOCHOK, CLIFTON.
BCU-SNIII