Relationships among hemolysis indicators and neuron-specific-enolase in patients undergoing veno-arterial extracorporeal membrane oxygenation.
ECMO
Extracorporeal membrane oxygenation
Hemolysis
NSE
Neuron-specific-enolase
Journal
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs
ISSN: 1619-0904
Titre abrégé: J Artif Organs
Pays: Japan
ID NLM: 9815648
Informations de publication
Date de publication:
10 Jul 2024
10 Jul 2024
Historique:
received:
07
06
2022
accepted:
22
05
2024
medline:
11
7
2024
pubmed:
11
7
2024
entrez:
10
7
2024
Statut:
aheadofprint
Résumé
Neuron-specific-enolase is used as a marker of neurological prognosis after cardiopulmonary resuscitation. It is also present in red blood cells and platelets. It is not known whether hemolysis increases the values of neuron-specific-enolase enough to clinically affect its interpretation in critically ill patients who are to be introduced to veno-arterial extracorporeal oxygenation. In this study, we examined the relationships among neuron-specific-enolase and hemolysis indicators such as free hemoglobin and lactate dehydrogenase after the introduction of veno-arterial extracorporeal oxygenation. Of the 91 patients who underwent veno-arterial extracorporeal membrane oxygenation in our hospital from January 1, 2018, to February 24, 2021, 68 patients survived for more than 24 h. Of these, 14 patients who were categorized into the better cerebral performance categories (1-3) and 19 patients who were categorized into the poor neurological prognosis category (4) were included. After the introduction of veno-arterial extracorporeal membrane oxygenation, neuron-specific-enolase was markedly higher in the poor neurological prognosis group than in the good neurological prognosis group (41.6 vs. 92.0, p = 0.04). A significant positive correlation was revealed between neuron-specific-enolase and free hemoglobin in the good neurological prognosis group (rs = 0.643, p = 0.0131). A similar relationship was observed for lactate dehydrogenase and neuron-specific-enolase in both the conscious (rs = 0.737, p = 0.00263) and non-conscious groups (rs = 0.544, p = 0.0176). When neuron-specific-enolase is used as a marker for neuroprognostic evaluation, an abnormally high value is likely to indicate the lack of consciousness, whereas a lower elevation should be interpreted with caution, taking into account the effects of hemolysis.
Identifiants
pubmed: 38987390
doi: 10.1007/s10047-024-01454-y
pii: 10.1007/s10047-024-01454-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Japanese Society for Artificial Organs.
Références
Lissner Östlund E, Levin H, Nielsen N, Frigyesi A, Lybeck A. Neuron-specific enolase and long-term neurological outcome after OHCA-A validation study. Resuscitation. 2021;168:206–13.
doi: 10.1016/j.resuscitation.2021.09.001
pubmed: 34508799
Isgrò MA, Bottoni P, Scatena R. Neuron-specific enolase as a biomarker: biochemical and clinical aspects. Adv Exp Med Biol. 2015;867:125–43.
doi: 10.1007/978-94-017-7215-0_9
pubmed: 26530364
Meric E, Gunduz A, Turedi S, Cakir E, Yandi M. The prognostic value of neuron-specific enolase in head trauma patients. J Emerg Med. 2010;38:297–301.
doi: 10.1016/j.jemermed.2007.11.032
pubmed: 18499387
Lascarrou JB, Miailhe AF, le Gouge A, Cariou A, Dequin PF, Reignier J, Coupez E, Quenot JP, Legriel S, Pichon N, Thevenin D. NSE as a predictor of death or poor neurological outcome after non-shockable cardiac arrest due to any cause: ancillary study of HYPERION trial data. Resuscitation. 2021;158:193–200.
doi: 10.1016/j.resuscitation.2020.11.035
pubmed: 33301887
Müller J, Bissmann B, Becker C, Beck K, Loretz N, Gross S, Amacher SA, Bohren C, Pargger H, Tisljar K, Sutter R. Neuron-specific enolase (NSE) predicts long-term mortality in adult patients after cardiac arrest: results from a prospective trial. Medicines (Basel). 2021;8:72.
doi: 10.3390/medicines8110072
pubmed: 34822369
Kimura F, Kadohama T, Kitahara H, Ise H, Nakanishi S, Akasaka N, Kamiya H. Serum neuron-specific enolase level as predictor of neurologic outcome after aortic surgery. Thorac Cardiovasc Surg. 2020;68:282–90.
doi: 10.1055/s-0038-1677511
pubmed: 30669174
Day IN, Thompson RJ. Levels of immunoreactive aldolase C, creatine kinase-BB, neuronal and non-neuronal enolase, and 14-3-3 protein in circulating human blood cells. Clin Chim Acta. 1984;136:219–28.
doi: 10.1016/0009-8981(84)90295-X
pubmed: 6692576
Tolan NV, Vidal-Folch N, Algeciras-Schimnich A, Singh RJ, Grebe SK. Individualized correction of neuron-specific enolase (NSE) measurement in hemolyzed serum samples. Clin Chim Acta. 2013;424:216–21.
doi: 10.1016/j.cca.2013.06.009
pubmed: 23778024
Mastroianni A, Panella R, Morelli D. Invisible hemolysis in serum samples interferes in NSE measurement. Tumori. 2020;106:79–81.
doi: 10.1177/0300891619867836
pubmed: 31394980
Safar P. Resuscitation after brain ischemia. Brain Fail Resusc. 1981;155:84.
R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna. 2021. https://www.R-project.org/ . Accessed 1 Mar 2022.
Schrage B, Rübsamen N, Becher PM, Roedl K, Söffker G, Schwarzl M, Dreher A, Schewel J, Ghanem A, Grahn H, Lubos E. Neuron-specific-enolase as a predictor of the neurologic outcome after cardiopulmonary resuscitation in patients on ECMO. Resuscitation. 2019;136:14–20.
doi: 10.1016/j.resuscitation.2019.01.011
pubmed: 30654013
Floerchinger B, Philipp A, Camboni D, Foltan M, Lunz D, Lubnow M, Zausig Y, Schmid C. NSE serum levels in extracorporeal life support patients-relevance for neurological outcome? Resuscitation. 2017;121:166–71.
doi: 10.1016/j.resuscitation.2017.09.001
pubmed: 28916477
Rother RP, Bell L, Hillmen P, Gladwin MT. The clinical sequelae of intravascular hemolysis and extracellular plasma hemoglobin: a novel mechanism of human disease. JAMA. 2005;293:1653–62.
doi: 10.1001/jama.293.13.1653
pubmed: 15811985
Shih AW, McFarlane A, Verhovsek M. Haptoglobin testing in hemolysis: measurement and interpretation. Am J Hematol. 2014;89:443–7.
doi: 10.1002/ajh.23623
pubmed: 24809098
Lim SK, Ferraro B, Moore K, Halliwell B. Role of haptoglobin in free hemoglobin metabolism. Redox Rep. 2001;6:219–27.
doi: 10.1179/135100001101536364
pubmed: 11642712
Lyu L, Long C, Hei F, Ji B, Liu J, Yu K, Chen L, Yao J, Hu Q, Hu J, Gao G. Plasma free hemoglobin is a predictor of acute renal failure during adult venous-arterial extracorporeal membrane oxygenation support. J Cardiothorac Vasc Anesth. 2016;30:891–5.
doi: 10.1053/j.jvca.2016.02.011
pubmed: 27238434
Hokka M, Egi M, Kubota K, Mizobuchi S. Perioperative serum free hemoglobin and haptoglobin levels in valvular and aortic surgery with cardiopulmonary bypass: their associations with postoperative kidney injury. J Cardiothorac Vasc Anesth. 2021;35:3207–14.
doi: 10.1053/j.jvca.2021.04.029
pubmed: 34052069
Haque A, Ray SK, Cox A, Banik NL. Neuron specific enolase: a promising therapeutic target in acute spinal cord injury. Metab Brain Dis. 2016;31:487–95.
doi: 10.1007/s11011-016-9801-6
pubmed: 26847611
pmcid: 4864119