Skip to main content
Erschienen in: Neurocritical Care 2/2010

01.04.2010 | Original Article

Comparison of the Predictability of Neurological Outcome by Serum Procalcitonin and Glial Fibrillary Acidic Protein in Postcardiac-Arrest Patients

verfasst von: Hiromi Hayashida, Tadashi Kaneko, Shunji Kasaoka, Chiyomi Oshima, Takashi Miyauchi, Motoki Fujita, Yasutaka Oda, Ryosuke Tsuruta, Tsuyoshi Maekawa

Erschienen in: Neurocritical Care | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

In past research, procalcitonin (PCT) and glial fibrillary acidic protein (GFAP) have been reported to be useful biomarkers in predicting neurological outcome after the return of spontaneous circulation (ROSC) following out-of-hospital cardiac arrest (CA), although they have only been studied separately. In this study, we compared the usefulness of PCT and GFAP in predicting neurological outcome.

Methods

This study was a retrospective, single-center analysis, conducted in the intensive-care unit of a university hospital. Twenty-one sequential post-CA patients were included. Serum samples were collected from patients at 12 and 24 h after ROSC. Serum PCT and GFAP were measured and compared in patients with favorable and unfavorable neurological outcomes, evaluated at 6 months using the Glasgow–Pittsburgh Cerebral Performance Categories.

Results

Serum PCT was significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.004 and 0.002, respectively). Serum GFAP was not significantly higher at 12 and 24 h in patients with unfavorable outcomes (P = 0.118 and 0.079, respectively). The combination of PCT and GFAP showed high predictive value for unfavorable outcomes (86.7% sensitivity and 100% specificity at 12 h; 100% sensitivity and 83.3% specificity at 24 h).

Conclusion

Serum PCT is a marker of unfavorable neurological outcome in post-CA patients, and is superior to serum GFAP in the early phase.
Literatur
1.
Zurück zum Zitat Fries M, Kunz D, Gressner AM, Rossaint R, Kuhlen R. Procalcitonin serum levels after out-of-hospital cardiac arrest. Resuscitation. 2003;59:105–9.CrossRefPubMed Fries M, Kunz D, Gressner AM, Rossaint R, Kuhlen R. Procalcitonin serum levels after out-of-hospital cardiac arrest. Resuscitation. 2003;59:105–9.CrossRefPubMed
2.
Zurück zum Zitat Kaneko T, Kasaoka S, Miyauchi T, et al. Serum glial fibrillary acidic protein as a predictive biomarker of neurological outcome after cardiac arrest. Resuscitation. 2009;80:790–4.CrossRefPubMed Kaneko T, Kasaoka S, Miyauchi T, et al. Serum glial fibrillary acidic protein as a predictive biomarker of neurological outcome after cardiac arrest. Resuscitation. 2009;80:790–4.CrossRefPubMed
3.
Zurück zum Zitat Tang BM, Eslick GD, Craig JC, McLean AS. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Dis. 2007;7:210–7.CrossRefPubMed Tang BM, Eslick GD, Craig JC, McLean AS. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Dis. 2007;7:210–7.CrossRefPubMed
4.
Zurück zum Zitat Adrie C, Adib-Conquy M, Laurent I, et al. Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome. Circulation. 2002;106:562–8.CrossRefPubMed Adrie C, Adib-Conquy M, Laurent I, et al. Successful cardiopulmonary resuscitation after cardiac arrest as a “sepsis-like” syndrome. Circulation. 2002;106:562–8.CrossRefPubMed
5.
Zurück zum Zitat Pelinka LE, Kroepfl A, Schmidhammer R, et al. Glial fibrillary acidic protein in serum after traumatic brain injury and multiple trauma. J Trauma. 2004;57:1006–12.CrossRefPubMed Pelinka LE, Kroepfl A, Schmidhammer R, et al. Glial fibrillary acidic protein in serum after traumatic brain injury and multiple trauma. J Trauma. 2004;57:1006–12.CrossRefPubMed
6.
Zurück zum Zitat Pelinka LE, Kroepfl A, Leixnering M, Buchinqer W, Raabe A, Redl H. GFAP versus S100B in serum after traumatic brain injury: relationship to brain damage and outcome. J Neurotrauma. 2004;21:1553–61.CrossRefPubMed Pelinka LE, Kroepfl A, Leixnering M, Buchinqer W, Raabe A, Redl H. GFAP versus S100B in serum after traumatic brain injury: relationship to brain damage and outcome. J Neurotrauma. 2004;21:1553–61.CrossRefPubMed
7.
8.
Zurück zum Zitat Brunkhorst FM, Wegscheider K, Forycki ZF, Brunkhorst R. Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis, and septic shock. Intensive Care Med. 2000;26:S148–52.PubMed Brunkhorst FM, Wegscheider K, Forycki ZF, Brunkhorst R. Procalcitonin for early diagnosis and differentiation of SIRS, sepsis, severe sepsis, and septic shock. Intensive Care Med. 2000;26:S148–52.PubMed
9.
Zurück zum Zitat Tiainen M, Roine RO, Pettilä V, Takkunen O. Serum neuron-specific enolase and S-100B protein in cardiac arrest patients treated with hypothermia. Stroke. 2003;34:2881–6.CrossRefPubMed Tiainen M, Roine RO, Pettilä V, Takkunen O. Serum neuron-specific enolase and S-100B protein in cardiac arrest patients treated with hypothermia. Stroke. 2003;34:2881–6.CrossRefPubMed
10.
Zurück zum Zitat Oppert M, Reinicke A, Müller C, Barckow D, Frei U, Eckardt KU. Elevations in procalcitonin but not C-reactive protein are associated with pneumonia after cardiopulmonary resuscitation. Resuscitation. 2002;53:167–70.CrossRefPubMed Oppert M, Reinicke A, Müller C, Barckow D, Frei U, Eckardt KU. Elevations in procalcitonin but not C-reactive protein are associated with pneumonia after cardiopulmonary resuscitation. Resuscitation. 2002;53:167–70.CrossRefPubMed
11.
Zurück zum Zitat Pfeifer R, Börner A, Krack A, Siqusch HH, Suber R, Fiqulla HR. Outcome after cardiac arrest: predictive value and limitations of the neuroproteins neuron-specific enolase and protein S-100 and the Glasgow coma scale. Resuscitation. 2005;65:49–55.CrossRefPubMed Pfeifer R, Börner A, Krack A, Siqusch HH, Suber R, Fiqulla HR. Outcome after cardiac arrest: predictive value and limitations of the neuroproteins neuron-specific enolase and protein S-100 and the Glasgow coma scale. Resuscitation. 2005;65:49–55.CrossRefPubMed
12.
Zurück zum Zitat Böttiger BW, Möbes S, Glätzer R, et al. Astroglial protein S-100 is an early and sensitive marker of hypoxic brain damage and outcome after cardiac arrest in humans. Circulation. 2001;103:2694–8.PubMed Böttiger BW, Möbes S, Glätzer R, et al. Astroglial protein S-100 is an early and sensitive marker of hypoxic brain damage and outcome after cardiac arrest in humans. Circulation. 2001;103:2694–8.PubMed
13.
Zurück zum Zitat Hachimi-Idrissi S, Van derAuwera M, Schiettecatte J, Ebinger G, Michotte Y, Huyghens L. S-100 protein as early predictor of regaining consciousness after out of hospital cardiac arrest. Resuscitation. 2002;53:251–7.CrossRefPubMed Hachimi-Idrissi S, Van derAuwera M, Schiettecatte J, Ebinger G, Michotte Y, Huyghens L. S-100 protein as early predictor of regaining consciousness after out of hospital cardiac arrest. Resuscitation. 2002;53:251–7.CrossRefPubMed
14.
Zurück zum Zitat Pelinka LE, Hertz H, Mauritz W, et al. Nonspecific increase of systemic neuron-specific enolase after trauma: clinical and experimental findings. Shock. 2005;24:119–23.CrossRefPubMed Pelinka LE, Hertz H, Mauritz W, et al. Nonspecific increase of systemic neuron-specific enolase after trauma: clinical and experimental findings. Shock. 2005;24:119–23.CrossRefPubMed
15.
Zurück zum Zitat Pelinka LE, Harada N, Szalay L, Jafarmadar M, Redl H, Bahrami S. Release of S100B differs during ischemia and reperfusion of the liver, the gut, and the kidney in rats. Shock. 2004;21:72–6.CrossRefPubMed Pelinka LE, Harada N, Szalay L, Jafarmadar M, Redl H, Bahrami S. Release of S100B differs during ischemia and reperfusion of the liver, the gut, and the kidney in rats. Shock. 2004;21:72–6.CrossRefPubMed
16.
Zurück zum Zitat Kaneko T, Yagi T, Todani M, et al. Serum glial fibrillary acidic protein has remarkable diagnostic value on traumatic brain injury in multiple trauma patients. Crit Care Med. 2008;36:47. Kaneko T, Yagi T, Todani M, et al. Serum glial fibrillary acidic protein has remarkable diagnostic value on traumatic brain injury in multiple trauma patients. Crit Care Med. 2008;36:47.
Metadaten
Titel
Comparison of the Predictability of Neurological Outcome by Serum Procalcitonin and Glial Fibrillary Acidic Protein in Postcardiac-Arrest Patients
verfasst von
Hiromi Hayashida
Tadashi Kaneko
Shunji Kasaoka
Chiyomi Oshima
Takashi Miyauchi
Motoki Fujita
Yasutaka Oda
Ryosuke Tsuruta
Tsuyoshi Maekawa
Publikationsdatum
01.04.2010
Verlag
Humana Press Inc
Erschienen in
Neurocritical Care / Ausgabe 2/2010
Print ISSN: 1541-6933
Elektronische ISSN: 1556-0961
DOI
https://doi.org/10.1007/s12028-009-9318-5

Weitere Artikel der Ausgabe 2/2010

Neurocritical Care 2/2010 Zur Ausgabe

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.