Neurological outputs in patients after the fibrillation of circulatory arrest

Pavlína Tůmová ^{1, 2} *, Milan Hromádka ³, Jitka Seidlerová Mlíková ⁴
¹ University of South Bohemia in České Budějovice, Faculty of Health and Social Sciences, České Budějovice, Czech Republic ² Stod Hospital / Hospitals of the Plzeň Region, Department of Internal Medicine, Stod, Czech Republic ³ Charles University, Faculty of Medicine in Plzeň, Cardiology Clinic, Plzeň, Czech Republic ⁴ Charles University, Faculty of Medicine in Plzeň, 2nd Internal Medicine Clinic, Plzeň, Czech Republic

Korespondenční autor: Pavlína Tůmová (tumova.pavlina@centrum.cz)

ISSN 1804-7181 (On-line)

Full verze:

Submitted:2. 11. 2020
Accepted: 8. 12. 2020
Published online: 31. 12. 2020

Summary

The prognosis in patients after the fibrillation of circulatory arrest, who underwent immediate cardio-pulmonary resuscitation, is uncertain. In order to predict a neurological output, we can use the laboratory parameter of neuron-specific enolase (NSE).

Goal: The goal of this study was to assess the neurological output in 56 patients after a successful cardiopulmonary resuscitation that was carried out during non-traumatic circulatory arrest by Cerebral Performance Categories (CPC) score, and to assess the possible predictive indicators during mild hypothermia at 33 °C or 36 °C.

Results: In 20 patients, the cause was acute myocardial infarction with elevated ST divisions (STEMI). In 36 patients, the cause of the fibrillation of circulatory arrest was different. The NSE value in surviving patients after 72 hours of hospitalization was set at 16.6 (12.9–24.6) μg/l (in the deceased it was set at 161.2 (37.8–180) μg/l), which statistically correlated with the neurological prognosis and mortality in both groups. The strategy of temperature management (33 °C or 36 °C) did not affect the patients’ neurological output. During discharge, the CPC score of 1–2 was present in 75% of patients after STEMI fibrillation arrest, and in 39% of patients after a fibrillation arrest from other causes.

Conclusions: Patients after STEMI fibrillation arrest had a better prognosis; a CPC score of 1–2 was present in 75% of patients. The NSE set 72 hours of hospitalization to predict the neurological outcome of patients.

Keywords: Cerebral Performance Categories (CPC); Fibrillation of circulatory arrest; Neurological output; Neuron-specific enolase

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