Cardiac arrest & resuscitation
Beyond blood-brain barrier disruption and molecular weight: compartmental kinetics of S100B and neuron-specific enolase (NSE) for neurological prognostication after cardiac arrest
Authors' conclusion
Serum NSE levels closely reflect the degree of BBB disruption and CSF levels, while S100B exhibits a transient early-phase profile, with decreased serum detectability over time, even in the presence of sustained CSF elevation or severe BBB disruption.
Study context
- Population
- Comatose adult out-of-hospital cardiac arrest (OHCA) survivors with paired serum and cerebrospinal fluid (CSF) NSE and S100B measurements at 0, 24, 48 and 72 h after ROSC59% poor outcome
- Participants
- 111 survivors
- Exposure
- Serum and CSF NSE vs S100B for 6-month poor neurological outcome after OHCA
- Outcome
- Prognostic performance (AUC) of serum and CSF NSE and S100B for poor neurological outcome (Cerebral Performance Category 3-5)
- Follow-up
- 6 months
Methodological details646 serum and 620 CSF samples analysed
- 646 serum and 620 CSF samples analysed
Main finding
As reported in the abstract
Prognostic performance (AUC) for 6-month poor neurological outcome
Serum NSE: time-dependent improvement in prognostic accuracy, peaking at H72
AUC 0.88
S100B: stable performance across all timepoints (all P > 0.4)
AUCs 0.79-0.85
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Serum and CSF S100B kinetics (poor outcome) | Poor outcome 0.80 (IQR 0.39–2.81) ng/mL |
- Serum and CSF S100B kinetics (poor outcome) — Serum S100B peaked at H0 and declined despite persistently elevated CSF levels at or above the upper detection limit
- ≥ 30 ng/mL
- Serum and CSF S100B kinetics (poor outcome): serum peak at H0
Blood-brain barrier (BBB) disruption (CSF/serum albumin quotient, QA)
- Peak at H24, median [IQR]
- 0.0282 [IQR 0.0150-0.120]
- At H72, median [IQR]
- 0.0228 [IQR 0.0147-0.0598]
- More severe in the poor outcome group at all timepoints (all P < 0.001)
NSE kinetics
- NSE progressively increased in both compartments, serum and CSF increasing in parallel over time
Original publication
Beyond blood-brain barrier disruption and molecular weight: compartmental kinetics of S100B and NSE for neurological prognostication after cardiac arrest. Crit Care. Published 4 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →