Investigating Novel and Conventional Biomarkers for Post-resuscitation Prognosis: The Role of Cytokeratin-18, Neuron-specific Enolase, and Lactate [post]

Beata Csiszar, Almos Nemeth, Zsolt Marton, Janos Riba, Peter Csecsei, Tihamer Molnar, Robert Halmosi, Laszlo Deres, Tamas Koszegi, Barbara Sandor, Kalman Toth, Peter Kenyeres
2021 unpublished
Introduction: We investigated the associations of cell death-related release of cytokeratin-18 (CK-18) and its caspase-cleaved form (CCCK-18) with outcomes, clinical parameters, and neuron-specific enolase (NSE) among cardiac arrest (CA) victims.Methods: We determined CK-18, CCCK-18, and NSE plasma concentrations within 6, at 24, and 72 post-CA hours of 54 successfully resuscitated patients. Baseline characteristics, laboratory, vital parameters, prognostic scores were recorded. The follow-up
more » ... s 30 days.Results: Neither the absolute values of CK-18, CCCK-18, CCCK-18/CK-18 ratio, or NSE, nor their kinetics showed significant difference according to survival and neurological outcome. CK-18 decreased in good renal function in contrast to renal failure. Lactate levels were increased in non-survivors and poor neurological outcomes. In receiver operator characteristic (ROC) analyses lactate was comparable with prognostic scores in predicting 30-day mortality and neurological outcome. The ROC curve of initial lactate indicated a cut-off as 4.90 mmol/L to predict 30-day mortality (specificity=80%; sensitivity=74%) and 6.00 mmol/L (specificity=80%; sensitivity=84%) for poor neurological outcome.Conclusion: This study was the first to investigate the post-resuscitation prognostic value of CK-18 and CCCK-18 with NSE. Although we could not prove their prognostic value, we confirmed the role of initial lactate in predicting mortality and neurological outcome in unselected resuscitated patients.
doi:10.21203/rs.3.rs-197502/v1 fatcat:kgdtmuwcoffunb7yjarpztdjxy