Plasma Neutrophil Gelatinase-associated Lipocalin (NGAL) as Early Biomarker for Renal Dysfunction and Good Neurologic Outcome in Out of Hospital Cardiac Arrest Patients

Postresuscitation disease is a constellation of disorders related to whole-body ischemia and reperfusion syndrome. It includes hypoxic damage in brain, liver, kidney, heart and other organ. In previous study more than one-third of patients resuscitation from out of hospital cardiac arrest developed renal dysfunction. In acute kidney injury, NGAL is an earlier marker compared with serum creatinine.

Cardiac arrest and severe asphyxia result in global brain ischemia. In previous study serum NGAL correlated with hypoxic ischemic encephalopathy in asphyxiated neonate.

This study was designed to assess serum NGAL level in postresuscitative patients to evaluate its relation to hypoxic brain injury severity, and its clinical utility for early detection of acute kidney injury in these patients.

Inclusion Criteria:

• 19 years and older
• Successful resuscitation from out of hospital cardiac arrest and spontaneous circulation time is longer than 20 min.
• GCS < 8

Exclusion Criteria:

• Pre-existing coma before cardiac arrest
• Mental change with other cause except cardiac arrest.(Ex. traumatic brain injury, cerebro-vascular accident.)
• Unstable vital sign (Systolic blood pressure is lower than 60mmHg)
• History of terminal illness.
• Coagulation deficiency.
• Pregnancy state or younger than 18 year
• Pre-existing end-stage renal disease or dependence on renal replacement therapy
• Transfer to other hospital and cannot know prognosis
• Withdrawal of care due to family wishes
• The patient arrives our hospital after 4 hours or longer from resuscitation.
• The patient refuses to sign the consent