[Biomarkers after resuscitation : Relevance in daily clinical practice for prognosis estimation and definition of therapeutic goals]. / Biomarker nach Reanimation : Relevanz im klinischen Alltag für Prognoseeinschätzung und Therapiezieldefinition.

ABSTRACT

BACKGROUND: The assessment of the neurological prognosis after cardiac arrest should be made using a multimodal 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. OBJECTIVES: Which biomarkers help in prognosis estimation and therapy target definition and are currently used in daily clinical practice? MATERIALS AND METHODS: Presentation 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 CONCLUSION: Neuron-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 48-72 h with a cutoff value of 90 ng/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.