Neuron Specific Enolase and Serum Electrolytes in Comatose Patients
Murtada Wafi Beden *
Al-Nasiriyah Technical institute, Sothern Technical University, Basra, Iraq.
*Author to whom correspondence should be addressed.
Abstract
Background: Coma is a profound state of unconsciousness in which the patient cannot be roused by external stimuli. The metabolic fingerprint of comatose patients is essential to identify the underlying molecular pathways and to use as a basis for developing specific therapies. In this article, the metabolic alterations associated with coma were focused on, focusing in particular on key biomarkers and pathways of its pathogenesis.
Methods: The study included 32 comatose patients with varying underlying reasons. After 48 hours of coma, serum electrolytes and neuron-specific enolase (NSE) were examined, the tests were repeated after 72-hour to determine the involvement of electrolytes and NSE in coma progression. The patients' coma outcomes were monitored using intensive care unit records.
Results: The results of the serum tests showed that there was a significant imbalance in the levels of Magnesium and Potassium, as they had decreased considerably. However, there was no significant change observed in the levels of Sodium during both tests. In addition, the levels of Calcium and neuron-specific enolase were found to be considerably increased. A moderate, positive correlation was observed between the duration of coma and the levels of neuron-specific enolase. On the other hand, a highly significant negative correlation was found between the levels of Calcium and Magnesium with the duration of the coma. This correlation was more pronounced in females. The cause of the brain injury also played a significant role in determining the outcome of the coma and its duration. For instance, patients with brain trauma due to road traffic accidents had a lower mortality rate and better prognosis than patients with anoxia or ischemia as the cause of coma. The latter group had worse outcomes such as death and vegetative states.
Conclusion: The findings suggest that etiology of TBI and electrolyte status in particular low magnesium, potassium together with high calcium and NSE are significant for the duration and outcome of coma and prediction.
Keywords: Serum electrolytes, etiology, comatose patients