Biomarkers after resuscitation. Relevance in daily clinical practice for prognosis estimation and definition of therapeutic goals

BackgroundThe assessment of the neurological prognosis after cardiac arrest should be made using amultimodal approach involving clinical, physical and laboratory findings. Here, biomarkers are of high importance. The reliable prognostication has far-reaching consequences for the patient on the further course of therapy and rehabilitation.ObjectivesWhich biomarkers help in prognosis estimation and therapy target definition and are currently used in daily clinical practice?Materials and methodsPresentation of the multimodal approach for prognosis generation in patients after resuscitation with hypoxic-ischemic encephalopathy with special consideration and discussion of various biomarkers.Results and conclusionNeuron-specific enolase (NSE) is the best-established predictive biomarker in patients with hypoxic-ischemic encephalopathy after cardiac arrest. In combination with other methods (clinical examination, physical testing) and considering possible interfering factors (hemolysis, tumor diseases), NSE is used after 48-72h with acutoff value of 90ng/ml. Most other biomarkers have so far only been studied in smaller groups or individual studies and thus cannot currently be routinely used outside of studies.