Predictors of Neurologic Outcome in Cardiac Arrest Patients Who Receive Therapeutic Hypothermia

Researchers at the Mayo Clinic found that cardiac arrest patients who receive therapeutic hypothermia changes how neurological prognosis is estimated.1 A high level of neuron-specific enolase (NSE), a substance detected in the blood that indicates the extent of brain damage, is no longer a valid indicator for patients who have received therapeutic hypothermia.


For the study, 190 patients, of whom more than 100 were treated with therapeutic hypothermia, underwent detailed neurologic exams, including NSE measurement. Typically high levels of NSE in the blood are reliable indicators of poor outcome after cardiac arrest in patients not treated with therapeutic hypothermia.


However, in patients who had been treated with hypothermia, the researchers found that the NSE level wasn’t sufficiently reliable to estimate the prognosis. Some patients in this group with elevated levels recovered well.


“That was a remarkable finding of our study that deserves more attention,” says Alejandro Rabinstein, MD, in a press release from the Mayo Clinic.


  1. Fugate JE, Wijdicks EF, Mandrekar J, et al. Predictors of neurologic outcome in hypothermia after cardiac arrest. Ann Neurology. 2010; 68(6):907—914. doi:10.1002/ana.22133

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