Novel biomarkers enable individualized early prediction of brain injury and neurological outcome after cardiac arrest

Each year, thousands of unconscious cardiac arrest (CA) patients are treated on Swedish intensive care units. 50% will not survive due to irreversible brain injury, causing ethical stress for health personnel and utilizing limited resources. Guidelines recommend prolonged treatment to avoid discontinuing care in patients with possibility of good outcome.

We have identified biomarkers with excellent potential to predict early outcome, namely the axonal markers Neurofilament light (NFL) and the Alzheimer dementia marker p-tau181.My research questions are 1) can outcome be predicted safely 24 hours after CA using biomarkers and routine methods, 2) are guidelines safe, and 3) does sedation influence prognostication of outcome.I will use blood biomarkers, computed tomography (CT), EEG, clinical examinations and long-term follow-up from 800 adult patients with an out-of-hospital CA recruited prospectively from the STEPCARE-trial between 2023-2026.

I previously focused on examining blood biomarkers for prediction of good and poor outcome, validated current guidelines for prognostication and established standardized radiological criteria for diagnosing severe hypoxic ischaemic brain injury on CT.

My first and last author papers have been published in Neurology, JAMA Neurology and Intensive Care Medicine (impact factor 9.9-41.8).By performing this prospective study I hope to improve individualized care for all unconscious cardiac arrest patients treated on intensive care units.