RESUMO
Objective To evaluate the prognostic value of the neuron-specific enolase ( NSE ) and bispectral index ( BIS) in patient with mild therapeutic hypothermia ( MTH) after cardiopulmonary resuscitation ( CPR ) .Methods Forty-six patients with restoration of spontaneous circulation ( ROSC ) after CPR were treated with MTH.The BIS values were recorded and the serum NSE was measured at the following times:24 h, 48 h, and 72 hours after ICU admission.Neurological outcome was classified according to the Pittsburgh cerebral performance category ( CPC 1 to 5) at 3 months after ICU discharge.Results Fourteen patients had a good neurological outcome with CPC score 1-3, and thirty-two patients had a poor neurological outcome with CPC 4-5 at 3 month.Compared with good outcome group, the NSE values were significantly higher in the poor outcome group on day 2 and day 3 after admission [48 h: (90.1 ±42.7) ng/mL vs.(33.2 ±17.5) ng/mL;72 h: (95.4 ±37.0) ng/mL vs. (29.2 ±17.0) ng/mL, P<0.05].NSE increased markedly in the poor neurological outcome group at 48h and 72h, and decreased significantly in the good group at the same time [△NSE 24 h-48 h: (37.3 ±28.7) ng/mL vs.(-10.7 ±12.1) ng/mL; △NSE 48 h-72h: (5.3 ±13.2) ng/mL vs.(-4.0 ±4.5 ng/mL), P<0.05].Over the 72 h of monitoring, the mean BIS values were lower in the poor outcome group compared to the good outcome group at 48 h [ (39.2 ±24.1) vs.(78.0 ±12.4); 72 h: (45.7 ±26.4) vs.(89.0 ±7.3), P<0.05].Conclusions The values of NSE and BIS were effective prognostic indicators for the neurological outcome of patients with MTH after CPR.