J Korean Soc Emerg Med.  2011 Apr;22(2):142-150.

Serial Measured Glucose Level and Neurological Outcome in Out of Hospital Cardiac Arrest Survivors Who Received Therapeutic Hypothermia

• Jang JY
• Lim YS
• Yang HJ
• Park WB
• Hyun SY
• Cho JS
• Kim JJ
• Lee MJ

Abstract

PURPOSE
In patients resuscitated from out-of-hospital cardiac arrest (OHCA), the influences of serial serum glucose and variability on neurological outcome are not well understood. We investigated the influence of serum glucose and variability on neurological outcome in OHCA survivors.
METHODS
Records of 105 OHCA survivors who received therapeutic hypothermia (TH) between April, 2007 and January, 2010 were retrospectively reviewed. By neurological prognosis at 6 months after restoration of spontaneous circulation, patients were divided to two groups based on cerebral performance category (CPC) score; 1-2 (good) and 3-5 (poor). The serial measured glucose level and glucose variability during 72 hours were compared between the groups.
RESULTS
The poor CPC group had statistically higher mean, median and maximum glucose level, but not minimal glucose, compared to the good CPC group. The poor CPC group also comparatively displayed higher standard deviation and time-glucose variability index (TGVI) of glucose level during 72 hours. Multiple logistic regression demonstrated that increased TGVI was significantly associated with poor neurological outcome (odds ratio 1.304, 95% confidence interval 1.078-1.578)
CONCLUSION
Serial glucose level and variability are strongly related with neurological outcome in post-resuscitated patients who received TH after OHCA. Further randomized controlled studies are needed.

Keyword

Heart arrest; Cardiopulmonary resuscitation; Glucose; Hyperglycemia; Hypothermia

MeSH Terms

Cardiopulmonary Resuscitation
Dinucleoside Phosphates
Glucose
Heart Arrest
Humans
Hyperglycemia
Hypothermia
Logistic Models
Out-of-Hospital Cardiac Arrest
Prognosis
Retrospective Studies
Survivors
Dinucleoside Phosphates
Glucose