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Neuron Specific Enolase (NSE): A Valuable Prognostic Factor of Central Nervous System Dysfunction Following Cardiac Surgery

Published online by Cambridge University Press:  01 February 2008

E.A. Konstantinou ,
K. Venetsanou ,
A.P. Mitsos ,
K.V. Mamoura ,
E.E. Theodosopoulou ,
T. Fotis  and
G. Baltopoulos
E.A. Konstantinou*
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
K. Venetsanou
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
A.P. Mitsos
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
K.V. Mamoura
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
E.E. Theodosopoulou
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
T. Fotis
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
G. Baltopoulos
Affiliation:
Evgenidion University Hospital, National and Kapodistrian University of Athens, Faculty of Nursing, Athens, Greece
*
Correspondence to. Evangelos A. Konstantinou, 18 Kivelis Street, 15238, Halandri, Athens, Greece. E-mail: ekonstan30@yahoo.com
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Abstract

Purpose

The aim of this study was to evaluate neuron specific enolase (NSE) as prognostic factor for CNS disorders developed in relation to cardiac surgery.

Patients and methods

A cohort of 92 patients were divided into two groups; the experimental group consisted of patients undergoing open-heart bypass surgery (50 patients) and the control group consisting of 42 patients undergoing general surgery procedures. The blood levels of NSE were measured in both groups before and 24 h after the operation and have been related to the incidence of the postoperative brain damage as well as to the duration of the extracorporeal circulation (ECC).

Results

The analysis of our results showed that the changes of blood NSE levels, before and immediately after ECC in open-heart surgery have been related to the incidence of postoperative brain dysfunction according to a specific mathematical equation. This incidence was raised also in relation to the age of the patient and the duration of ECC. On the contrary, NSE seems to have no prognostic value in general surgery.

Conclusion

NSE can be used in cardiac surgery as a simple and reliable prognostic factor to predict postoperative brain dysfunction.

Keywords

Neuron specific enolase (NSE)prognosispostoperative CNS disorderscardiac surgery
Type
Original Article
Information
British Journal of Anaesthetic & Recovery Nursing , Volume 9 , Issue 1 , February 2008 , pp. 22 - 28
Copyright
Copyright © British Association of Anaesthetic and Recovery Nursing 2008

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References

Aberg, T, Ronguist, G, TydenH, H, et al. Adverse effects on the brain in cardiac operations as assessed by biochemical, psychometric, and radiologic methods. The Journal of Thoracic Cardiovascular Surgery 1984; 87: 99–105.CrossRefGoogle ScholarPubMed
Adrian, L, Radinowicz, N, JorgeD, D, et al. Neuron-Specific Enolase is increased after non-convulsive status epilepticus. Epilepsia 1995; 136: 302–307.Google Scholar
Artru, A, Michenfelder, J. Cerebral protective, metabolic and vascular effects of phenytoin. Stroke 1980; 11: 377–382.CrossRefGoogle ScholarPubMed
Chang, SF, Suh, JW, ChoiJW, JW, et al. Diagnostic pitfalls of Merkel cell carcinoma and dramatic response to chemotherapy. Journal of Dermatology 1998; 25: 322–331.CrossRefGoogle ScholarPubMed
Evans, MC, Swan, JH, Meldrum, BS. An adenosine analogue, 2 chloroadenosine, protects against long term development of ischemic cell loss in the rat hippocampus. Neuroscience Letters 1987; 83: 287–292.CrossRefGoogle ScholarPubMed
Fossa, SD, Klepp, O, Paus, E. Neuron specific enolase : a serum marker in seminoma? British Journal of Cancer 1992; 65: 297–299.CrossRefGoogle ScholarPubMed
Frank, KA, Heller, SS, KornfeldDS, DS, et al. Long term effects of open heart surgery on intellectual functioning. The Journal of Thoracic Cardiovascular Surgery 1972; 64: 811–815.CrossRefGoogle ScholarPubMed
Hardemark, HG, Ericsson, N, KotwicaZ, Z, et al. S-100 Protein and NSE in CSF after experimental traumatic or focal ischemic brain damage. Journal of Neurosurgery 1989; 71: 727–731.CrossRefGoogle ScholarPubMed
Hardemark, HG, Persson, L, BolanderHG, HG, et al. NSE is a marker of cerebral ischemia and infarct size in rat cerebrospinal fluid. Stroke 1988; 19: 1140–1144.CrossRefGoogle Scholar
Isgro, F, Schmidt, C, Pohl, P, Saggau, W.A predictive parameter in patients with brain related complications after cardiac surgery? European Journal of Cardiothoracic Surgery 1997; 11: 640–644.Google Scholar
Ishiguro, Y, Kato, K, ItoT, T, et al. Nervous system-specific enolase in serum as a marker for neuroblastoma. Pediatrics 1983; 72: 696–700.CrossRefGoogle ScholarPubMed
Johnsson, P. Markers of cerebral ischemia after cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia 1996; 10: 120–126.CrossRefGoogle ScholarPubMed
Johnsson, P, Lundqvist, C, LindgrenA, A, et al. Cerebral complications after cardiac surgery assessed by S-100 and NSE levels in blood. Journal of Cardiothoracic and Vascular Anesthesia 1995; 9: 1–7.CrossRefGoogle ScholarPubMed
Johnsson, P, Lundqvist, C, LindgrenA, A, et al. Cerebral complications after cardiac surgery assessed by S-100 and NSE levels in blood. Journal of Cardiothoracic and Vascular Anesthesia 1996; 9: 694–699.CrossRefGoogle Scholar
Ke Ping, X, Shang Lian, L, Chuo, N. Immunohistochemical evidence of neuronal and glial differentiation in retinoblastoma. British Journal of Ophthalmology 1995; 79: 771–776.Google Scholar
Kirino, T, Brightman, MW, OertelWH, WH, et al. Neuron-specific enolase as an index of neuronal regeneration and reinnervation. Neuroscience 1983; 3: 915–923.CrossRefGoogle ScholarPubMed
Lorenz, J, Dippold, W. Neuron-specific enolase: a marker for malignant melanoma. Journal of National Cancer Institute 1989; 81: 1754–1755.CrossRefGoogle ScholarPubMed
Massaron, S, Seregni, E, LukschR, R, et al. Neuron-specific enolase evaluation in patients with neuroblastoma. Tumour Biology 1998; 19: 261–268.CrossRefGoogle ScholarPubMed
McKibbin, DW, Gott, VL, HutckinS, S, et al. Fatal cerebral atheromatous embolization after cardiopulmonary bypass. Journal of Thoracic and Cardiovascular Surgery 1976; 71: 741–745.CrossRefGoogle ScholarPubMed
Mokuno, K, Yasuda, T, SugimuraK, K, et al. Cerebrospinal fluid neuron specific enolase (NSE) and S-100b protein in Guillain Barre syndrome – their relations to prognosis. Rin Shin 1992; 32: 535–537.Google ScholarPubMed
Moore, BW, McGregor, T. Chromatographic and electrophoretic fractionation of soluble proteins of brain and liver. Journal of Biological Chemistry 1965; 240: 1647–1653.CrossRefGoogle ScholarPubMed
Pearson, DT, Holden, MP, PosladSS, SS, et al. A clinical evaluation of the gas transfer characteristics and gaseous microemboli production of two bubble oxygenators. Life Support Systems 1984; 2: 252–256.Google ScholarPubMed
Roine, RR, Somer, H, KasteM, M, et al. Neurological outcome after out-of-hospital cardiac arrest. Prediction by cerebrospinal fluid enzyme analysis. Archives of Neurology 1989; 46: 753–756.CrossRefGoogle ScholarPubMed
Savageau, JA, Stanton, BA, Jenkins, CD, Frater, RW. Neuro-psychological dysfunction following elective cardiac operation: Early assessment. Journal of Thoracic and Cardiovascular Surgery 1982; 84: 595–600.CrossRefGoogle Scholar
Sellman, M, Ivert, T, Ronquist, G, CaesariniK, K, et al. Central nervous system damage during cardiac surgery assessed by 3 different biochemical markers in cerebrospinal fluid. Scandinavian Journal of Thoracic and Cardiovascular Surgery 1992; 26: 39–45.CrossRefGoogle ScholarPubMed
Steen, PA, Newberg, LA, Milde, JH, Michenfelder, JD. Hypothermia and barbiturates: individual and combined effects on canine cerebral oxygen consumption. Anesthesiology 1983; 58: 527–532.CrossRefGoogle ScholarPubMed
Taylor, KM, Devlin, BJ, MittraSM, SM, et al. Assessment of cerebral damage during open heart surgery. A new experimental model. Scandinavian Journal of Thoracic and Cardiovascular Surgery 1980; 14: 197–203.CrossRefGoogle ScholarPubMed
Zeltzer, PM, Parma, AM, DaltonA, A, et al. Raised neuron-specific enolase in serum of children with metastatic neuroblastoma. Lancet 1983; 2: 361–363.CrossRefGoogle ScholarPubMed
Zeltzer, PM, Schneider, SL, Marangos, PJ, Zweig, MH. Differential expression of neural isozymes by human medulloblastomas and gliomas and neuroectodermal cell lines. Journal of National Cancer Institute 1986; 77: 625–631.CrossRefGoogle ScholarPubMed
Zerri, P, Bodemer, M, RackerS, S, et al. Cerebrospinal fluid concentration of neuron-specific enolase in diagnosis of Creutzfeldt Jacob disease. Lancet 1995; 24: 1609–1610.CrossRefGoogle Scholar
Zomzely-Neurath, CE. Enolase. In: Lajtha A (ed.). Handbook of Neuro-chemistry (2nd edn). New York: Plenum, 1983, 403–433.CrossRefGoogle Scholar