International Journal of Clinical Case Reports, 2025, Vol.15, No.6, 259-270 http://medscipublisher.com/index.php/ijccr 259 Review Article Open Access Molecular Monitoring of Brain Injury Markers During Post-CPR Nursing in the Emergency Department MinLi The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310009, Zhejiang, China Corresponding email: limin@qq.com International Journal of Clinical Case Reports 2025, Vol.15, No.6 doi: 10.5376/ijccr.2025.15.0027 Received: 02 Sep., 2025 Accepted: 05 Oct., 2025 Published: 21 Nov., 2025 Copyright © 2025 Li, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Li M., 2025, Molecular monitoring of brain injury markers during post-CPR nursing in the emergency department, International Journal of Clinical Case Reports, 15(6): 259-270 (doi: 10.5376/ijccr.2025.15.0027) Abstract This study explored the research progress and nursing implications of molecular monitoring of biomarkers for brain injury in the emergency department (ED) after cardiopulmonary resuscitation (CPR), analyzed the roles of traditional and emerging biomarkers in the early identification of brain injury and the assessment of neurological prognosis, and summarized the advantages of multi-biomarker combination and multimodal prediction models in improving prognosis accuracy. It also elaborates on the application of specimen selection and monitoring time Windows, result interpretation, risk stratification, comprehensive brain protection and individualized nursing pathways, emphasizing the importance of multidisciplinary collaboration and quality management in standardized monitoring. After comparing the differences in research and practice at home and abroad, it is pointed out that there are still problems such as insufficient sample size, inconsistent detection and threshold standards, and insufficient transformation of some new markers at present. In the future, it is necessary to better integrate molecular monitoring into the standardized and individualized nursing system after CPR in the emergency department through large-sample multi-center research, standardization of detection processes and construction of localization paths. To improve the neurological prognosis of survivors of cardiac arrest. Keywords Cardiopulmonary resuscitation; Emergency; Department; Brain injury Biomarker; Molecular monitoring I Introduction Cardiac arrest is an emergency with acute onset and a high fatality rate. Although cardiopulmonary resuscitation (CPR) techniques are constantly advancing, brain damage after resuscitation remains the main cause of death or long-term disability for patients. Epidemiological studies have shown that among patients receiving advanced resuscitation treatments such as extracorporeal cardiopulmonary resuscitation, approximately a quarter will develop acute brain injury, among which hypoxic-ischemic brain injury is the most common. Even if patients can survive until discharge, only a few have good neurological recovery, which is sufficient to demonstrate the significant impact of brain injury after cardiopulmonary resuscitation on patients and the medical system (Taccone et al., 2024). The emergency department (ED) is usually the first visit place for such patients. Here, a rapid and accurate assessment of the patient's neurological condition is crucial for subsequent treatment and prognosis judgment. There are significant deficiencies in evaluating brain injury in patients after cardiopulmonary resuscitation in the emergency department using traditional neurological examinations, imaging methods (such as CT), and clinical scoring systems. Sedation therapy, metabolic disorders or targeted body temperature control can all affect clinical examination results, making it difficult to reliably predict prognosis in the early stage (Hoiland et al., 2022; Shen et al., 2023). Although imaging examinations can detect abnormalities in brain structure, they are not sensitive enough to early or minor injuries, and often require patient transfer, which poses risks for patients with unstable conditions (Campagna et al., 2025). Furthermore, the existing clinical imaging diagnostic criteria are sometimes not uniform enough, which may lead to patients being exposed to unnecessary radiation and also waste medical resources. All these issues indicate that we need an auxiliary tool that can objectively, rapidly and stably assess the degree and development of brain injury after acute resuscitation.
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