Assessment of neurologic damage: creatine kinase-BB assay after cardiac arrest

The assay of cerebrospinal fluid creatine kinase-BB (CK-BB) after cardiac arrest has demonstrated a relationship between CK-BB activity and neurologic recovery; a high concentration of cerebrospinal fluid CK-BB can be associated with lower Glasgow Coma Scale scores, intracranial pressure plateau waves, and histologic brain damage on death. Analysis of cerebrospinal fluid CK-BB is most reliable when it is done within 48 to 72 hours of the arrest. The appearance of serum CK-BB after a cardiac arrest indicates global ischemia, but has not been shown to be a reliable indicator for outcome, because of its rapid inactivation in the body. However, investigations into methods of reactivation of CK-BB show promise in terms of future use of this assay technique.