IMR Press / FBS / Volume 2 / Issue 2 / DOI: 10.2741/S90

Frontiers in Bioscience-Scholar (FBS) is published by IMR Press from Volume 13 Issue 1 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Clinical biomarkers in brain injury: a lesson from cardiac arrest
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1 Department and School of Anesthesia and Intensive Care, Catania University Hospital, Via S Sofia 78, 95125 Catania, Italy
2 Department of Biochemistry, Medical Chemistry and Molecular Biology, University of Catania, V.le Andrea Doria 6, 95125 Catania, Italy
3 IRCCS Associazione Oasi Maria S.S., Institute for Research on Mental Retardation and Brain Aging, Via Conte Ruggero 73, 94018 Troina (EN), Italy
4 Weil Institute of Critical Care Medicine, 35100 Bob Hope DR, Rancho Mirage, CA, 92270, USA
5 Department of Anaesthesia, Intensive Care, and Emergency, S. Maria degli Angeli Hospital, Via Montereale 24, 33170 Pordenone, Italy

*Author to whom correspondence should be addressed.

Academic Editor: Giovanni Li Volti

Front. Biosci. (Schol Ed) 2010, 2(2), 623–640; https://doi.org/10.2741/S90
Published: 1 January 2010
(This article belongs to the Special Issue Biochemical markers in biological fluids)
Abstract

Cardiac arrest (CA) is the primary cause of death in industrialized countries. Successful resuscitation rate is estimated of about 40%, but a good neurological outcome remains difficult to achieve. The majority of resuscitated victims suffers of a pathophysiological entity termed as "post resuscitation disease". Today's efforts are mainly pointed to the chain of survival, often devoting less attention to post-resuscitation care. Resuscitated patients are often victims of nihilistic therapeutic approach, with clinicians failing to promptly institute strategies that mitigate the ischemia-reperfusion injury to vital organs. Only after 72 hours prognostication can be realistically attempted. Neurological evaluation relies on a combination of clinical, instrumental and laboratoristic parameters, since no one alone holds a specificity of 100%. Biochemical markers, such as neuron specific enolase and S-100b, may contribute to predict prognosis after CA. To the contrary, when used individually the necessary precision remains poorly characterized. Biochemical studies suffer from substantial methodological differences hampering attempts to summarize their findings. We review the information available on biochemical markers of brain damage for neurological prognostication after CA.

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