Friday September 11, 2009 (pediatric pearl)
Neuron Specific Enolase (NSE) and S-100 as markers of outcomes in pediatric cardiac arrest

NSE is a dimeric glycoprotein found in neurons and neuroectodermal cells. S-100B is a calcium binding protein found primarily in the astroglial and Schwann cells. At nanomolar concentrations it promotes astroglial proliferation and neuronal differentiation, but at micromolar concentrations it induces astroglial and neuronal cell death.

The timing, intensity, and duration of serum NSE and S-100B biomarker concentration patterns are associated with neurologic and survival outcomes following in or out-of-hospital cardiac arrest pediatric cardiac arrest.

For NSE a cutoff level of 51 µg/L at 48 hrs resulted in a sensitivity of only 50% for poor outcome while achieving a specificity of 100%.With these derived cutoffs the posttest probability of NSE for poor outcome is 99%, which is increased from the pretest probability of poor outcome of 54%. The addition of NSE testing may allow clinicians to increase their prediction of poor outcome in this population.



Reference: Click to get abstract

Neuron-specific enolase and S-100B are associated with neurologic outcome after pediatric cardiac arrest - Pediatric Critical Care Medicine 10(4), July 2009, pp 479-490