Biochemical markers for brain damage after carbon monoxide poisoning

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Abstract
Background: Carbon monoxide poisoning is associated with high mortality and a substantial risk for brain damage in survivors. Evidence for acute brain dysfunction may be obtained by measuring concentrations of suitable biochemical markers. We hypothesized that increased serum concentrations of Neuron‐specific enolase (NSE) and S‐100β protein could be detected after carbon monoxide poisoning and that the concentration would correlate with the severity of intoxication. Methods: Prospective non‐interventional study in the university hospital. We included 20 patients admitted for hyperbaric treatment due to carbon monoxide poisoning. Serum levels of NSE and S‐100β protein were measured in all patients on admission and after 12, 24, 36 and 48 h. As a control group, we included 20 patients who underwent elective hyperbaric treatment. Results: Serum concentrations of NSE and S‐100β protein were not significantly different from the controls, with median values at admission being 10.6 vs. 9.7 µg l−1 and 0.15 vs. 0.13 µg l−1, respectively (P = 0.82 and P = 0.38). The concentrations did not change significantly during the sampling period. We were unable to show any significant relation to level of consciousness. Conclusion: Blood concentrations of NSE and S‐100β protein were not significantly increased after carbon monoxide poisoning and do not seem to be related to a history of unconsciousness.