Objective To investigate the predictive value of serum neuron-specific enolase(NSE)level on prognosis and neuroiogical outcome in children early after in-hospital cardiopulmonary resuscitation(CPR).Methods From January 2006 to December 2008,Children who occurred in-hospital cardiorespiratory arrest and achieved return of spontaneous circulation(ROSC) by CPR were included in study and divided into dead group and survival group.The survival children were folowed up 6 months and divided into poor neurological outcome group and good outcome group according to Pediatric Cerebral Performance Category(PCPC).Serum samples were collected at 24-36 hours after ROSC.Patients were evaluated in terms of age,sex,arrest type,duration of CPR,Glasgow coma score(GCS),pupil reflex to light,need of sedation,serum levels of NSE and time interval to blood sampling.The NSE level when diagnostic specificity was 100% and sensitivity was highest to prognosis and neurological outcome was defined cut-off value,and calculated positive predict value(PPV),negative predict value(NPV)and accuracy,respectively.Results Eighty-seven cases were remained ultimately.Of the 87 cases,19 cases achieved ROSC,19 cases were survival to discharge.Followed up 6 months,12 of 19 cases were poor neurological outcome and 7 cases were good.Conclusion Of duration of CPR,GGS,pupil reflex to light,need of sedation and serum NSE level between different groups(dead vs.survival groups,poor neurological outcome group vs.good outcome group)showed signifficent difference(P<0.05).Positive correlation was observed between serum NSE level and duration of CPR(r=0.901.P=0.00).and negative correlation between scrum NSE level and GCS(r=-0.813,P=0.00).The area of under curve(AUC)of receiver operation character (ROC)curve of NSE to death after ROSC was 0.846±0.065(95%CI:0.720-0.973,P=0.00).When the SP was 100%,the cut-off value of 90.6ng/ml was established and Se of 20.8% was obtained,with PPV,NPV and accuracy were 100%,50% and 53.5%,respectively:The AUC of ROC curve of NSE to poor neurological outcome was 0.929±0.072(95% CI:0.788-1.069,P=0.002).the cut-off value of 50.7ng/ml was established and Se of 50% was obtained,with PPV,NPV and accuracy were 100%,53.8%and 68.4%,respectively.Conclusion Early determination of serum NSE levels is a valuable method for predicting mortality and poor neurological outcome in in-hospital arrest children. Key words: Neuron-specific enolase; Cardlopulmonary resuscitation; Outcome; Neurologic children