Serum neuron specific enolase and malondialdehyde in patients after out-of-hospital cardiac arrest.

BACKGROUND: Sudden cardiac arrest (CA) is a leading cause of death in Europe. The victims of CA need immediate cardiopulmonary resuscitation (CPR). Patients resuscitated due to CA have high mortality rate. Prognostic evaluation based on clinical observation is uncertain and would benefit from the use of biochemical markers of hypoxic brain damage. Multiple factors of brain origin can be measured in blood.
OBJECTIVE: The purpose of this study was to validate the use of the serum neuron-specific enolase (NSE) and malondialdehyde (MDA) concentrations for predicting in-hospital death, after resuscitation from out-of-hospital CA. Neuronal damage and impairment of the blood-brain-barrier integrity can be detected by the release of NSE into cerebrospinal fluid and eventually into the blood. MDA represents a product of lipid peroxide decomposition reactions.
METHODS: In a prospective study of 35 consecutive survivors of out-of-hospital CA, serum samples were obtained within 24, 72 and 168 h after the CA. NSE and MDA concentrations were measured, relationship between concentration in group of in-hospital death and survived patients were examined. Results There was a significant difference in NSE concentration between survivors and dead group on 1st day of measurement, marginally significant difference on 3rd day and no statistically significant difference in NSE on 7th day of measurement. There was marginally significant difference in MDA levels in both groups in all days of measurements.
CONCLUSION: Estimation serum concentrations of NSE but not MDA seems to be a predictor of fate of patients after CA. The exact nature of oxidative stress can only be resolved by further studies.