• LascarrouJean-BaptisteJBMedecine Intensive Reanimation, University Hospital Centre, Nantes, France; Paris Cardiovascular Research Centre, INSERM U970, Paris, France; AfterROSC Network, France. Electronic address: jeanbaptiste.lascarrou@chu-nantes.fr., Arnaud-Félix Miailhe, Amélie le Gouge, Alain Cariou, DequinPierre-FrançoisPFINSERM CIC1415, CHRU de Tours, Tours, France; Medical Intensive Care Unit, University Hospital Centre, Tours, France; Université de Tours, Tours, France., Jean Reignier, Elisabeth Coupez, QuenotJean-PierreJPMedical Intensive Care Unit, University Hospital Centre, Dijon, France., Stephane Legriel, Nicolas Pichon, Didier Thevenin, Thierry Boulain, Jean-Pierre Frat, Sylvie Vimeux, Gwenhael Colin, and François Desroys du Roure.
• Medecine Intensive Reanimation, University Hospital Centre, Nantes, France; Paris Cardiovascular Research Centre, INSERM U970, Paris, France; AfterROSC Network, France. Electronic address: jeanbaptiste.lascarrou@chu-nantes.fr.
• Resuscitation. 2021 Jan 1; 158: 193-200.

PurposePrognostication of hypoxic-ischaemic brain injury after resuscitation from cardiac arrest is based on a multimodal approach including biomarker assays. Our goal was to assess whether plasma NSE helps to predict day-90 death or poor neurological outcome in patients resuscitated from cardiac arrest in non-shockable rhythm.MethodsAll included patients participated in the randomised multicentre HYPERION trial. Serum blood samples were taken 24, 48, and 72 h after randomisation; pre-treated, aliquoted, and frozen at -80 °C at the study sites; and shipped to a central biology laboratory, where the NSE assays were performed. Primary outcome was neurological status at day 90 assessed by Cerebral Performance Category (1 or 2 versus. 3, 4 or 5).ResultsNSE was assayed in 235 assessable blood samples from 101 patients. In patients with good versus poor outcomes, median NSE values at 24, 48, and 72 h were 22.6 [95%CI, 14.6;27.3] ng/mL versus 33.6 [20.5;90.0] ng/mL (p < 0.04), 18.1 [11.7;29.7] ng/mL versus 76.8 [21.5;206.6] ng/mL (p < 0.0029), and 9 [6.1;18.6] ng/mL versus 80.5 [22.9;236.1] ng/mL (p < 0.001), respectively. NSE at 48 and 72 h predicted the neurological outcome with areas under the receiver-operating curve of 0.79 [95%CI, 0.69;0.96] and 0.9 [0.81;0.96], respectively. NSE levels did not differ significantly between the groups managed at 33°C and 37°C (p = 0.59).ConclusionsData from a multicentre trial on cardiac arrest with a non-shockable rhythm due to any cause confirm that NSE values at 72 h are associated with 90-day outcome. NSE levels did not differ significantly according to the targeted temperature.Registration IdentifierClinicalTrial NCT02722473.Copyright © 2020. Published by Elsevier B.V.

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