Akin M, Garcheva V, Sieweke J, et al. - Neurological damage following out-of-hospital cardiac arrest (OHCA) is assessed using neuron-specific enolase (NSE) and S-100b, with small normothermic cohorts assessed to derive cut-offs, so researchers here investigated if similar cut-offs are relevant to patients treated with hypothermia. Two hundred and fifty one patients with OHCA who were treated with hypothermia but without routine prognostication were investigated. Forty-one percent of these patients had good neurological outcomes (CPC ≤ 2). Increased mortality was observed in correlation with elevated neuromarkers, older age and absence of ST-segment elevation after ROSC. Survivors having a poor neurological outcome was also correlated with history of cerebrovascular events, sepsis, and higher admission lactate. For predicting mortality and poor neurological outcome, thresholds for NSE and S-100b are similar in OHCA patients receiving therapeutic hypothermia as in those reported before the use of hypothermia. However, given the insufficient specificity of both biomarkers for predicting mortality or poor neurological outcome on their own, they should only be used in combination with other recommended methods, such as EEG and imaging, in clinical decision making.