Plasma tau protein in comatose patients after cardiac arrest treated with therapeutic hypothermia

Mörtberg, Erik; Zetterberg, Henrik; Nordmark, Johanna; Blennow, Kaj; Catry, Cindy; Decraemer, Hilde; Vanmechelen, Eugeen; Rubertsson, Sten

doi:10.1111/j.1399-6576.2011.02505.x

Cited by 57 publications

(75 citation statements)

References 42 publications

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“…This patient had a good outcome and peaked at 20.7 μg/L, well below the 33 μg/L cut-off, which has been suggested in guidelines [71]. Other brain biomarkers that have been studied after CA without submersion include S-100B [166, 173, 174], GFAP [175], and tau [176]. …”

Section: Biomarkersmentioning

confidence: 97%

Brain Resuscitation in the Drowning Victim

et al. 2012

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Drowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence-based consensus effort to provide recommendations for management and investigation of the drowning victim. Epidemiology, brain-oriented prehospital and intensive care, therapeutic hypothermia, neuroimaging/monitoring, biomarkers, and neuroresuscitative pharmacology are addressed. When cardiac arrest is present, chest compressions with rescue breathing are recommended due to the asphyxial insult. In the comatose patient with restoration of spontaneous circulation, hypoxemia and hyperoxemia should be avoided, hyperthermia treated, and induced hypothermia (32–34 °C) considered. Arterial hypotension/hypertension should be recognized and treated. Prevent hypoglycemia and treat hyperglycemia. Treat clinical seizures and consider treating non-convulsive status epilepticus. Serial neurologic examinations should be provided. Brain imaging and serial biomarker measurement may aid prognostication. Continuous electroencephalography and N20 somatosensory evoked potential monitoring may be considered. Serial biomarker measurement (e.g., neuron specific enolase) may aid prognostication. There is insufficient evidence to recommend use of any specific brain-oriented neuroresuscitative pharmacologic therapy other than that required to restore and maintain normal physiology. Following initial stabilization, victims should be transferred to centers with expertise in age-specific post-resuscitation neurocritical care. Care should be documented, reviewed, and quality improvement assessment performed. Preclinical research should focus on models of asphyxial cardiac arrest. Clinical research should focus on improved cardiopulmonary resuscitation, re-oxygenation/reperfusion strategies, therapeutic hypothermia, neuroprotection, neurorehabilitation, and consideration of drowning in advances made in treatment of other central nervous system disorders.

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Section: Biomarkersmentioning

confidence: 97%

Brain Resuscitation in the Drowning Victim

et al. 2012

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“…101,102 Since collection of peripheral blood samples is considerably easier than collection of CSF in routine clinical practice, many candidate CSF biomarkers of mild TBI have also been assessed in peripheral blood (Table 1). The low concentration of potential biomarkers in peripheral blood is a technical limitation to the use of most standard immunoassays.…”

Section: Currently Available Fluid Biomarkersmentioning

confidence: 99%

Biomarkers of mild traumatic brain injury in cerebrospinal fluid and blood

2013

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Mild traumatic brain injury (TBI), which is defined as a head trauma resulting in a brief loss of consciousness and/or alteration of mental state, is usually benign, but occasionally causes persistent and sometimes progressive symptoms. Whether a threshold for the amount of brain injury and/or individual vulnerability might contribute to the development of these long-term consequences is unknown. Furthermore, reliable diagnostic methods that can establish whether a blow to the head has affected the brain (and in what way) are lacking. In this Review, we discuss potential biomarkers of injury to different structures and cell types in the CNS that can be detected in body fluids. We present arguments in support of the need for further development and validation of such biomarkers, and for their use in assessing patients with head trauma in whom the brain might have been affected. Specifically, we focus on the need for such biomarkers in the management of sports-related concussion, the most common cause of mild TBI in young individuals, to prevent long-term neurological sequelae due to concussive or subconcussive blows to the head.

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“…14 Of the candidate blood biomarkers, most data are available for neuron-specific enolase (NSE) and S-100B, but other biomarkers have also been investigated. 11,13,[15][16][17][18][19] NSE is a dimeric enzyme, mainly expressed in neurons, and its half-life is estimated to 24-30 h. 13 Red blood cells contain NSE, and therefore, hemolysis affects NSE levels. 11,13 Increased NSE concentrations after CA are associated with poor outcome in comatose patients, but there is as yet no established cut-off value for this marker.…”

Section: Introductionmentioning

confidence: 99%