Blood Glucose Concentration After Cardiopulmonary Resuscitation Influences Functional Neurological Recovery in Human Cardiac Arrest Survivors

• Published in: Journal of cerebral blood flow and metabolism 1997-04, Vol.17 (4), p.430-436
• Main Authors: Müllner, Marcus, Sterz, Fritz, Binder, Michael, Schreiber, Wolfgang, Deimel, Alexander, Laggner, Anton N.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Blood Glucose - analysis; Cardiology. Vascular system; Cardiopulmonary Resuscitation; Female; Heart; Heart Arrest - blood; Heart Arrest - physiopathology; Heart Arrest - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Nervous System - physiopathology; Osmolar Concentration; Time Factors; Treatment Outcome
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1097/00004647-199704000-00008

Experimental data suggest that postischemic blood glucose concentration plays an important role in modulating both ischemic cerebral infarction and selective neuronal necrosis. This study investigated the association between functional neurological recovery and blood glucose concentrations in human cardiac arrest survivors. A group of 145 nondiabetic patients were evaluated after witnessed ventricular fibrillation cardiac arrest. Data regarding cardiac arrest were collected according to an internationally accepted protocol immediately after arrival. Blood glucose was measured on admission and 6, 12, and 24 h thereafter. To control for duration of cardiac arrest and cardiogenic shock, both known to influence outcome as well as blood glucose, levels, Spearman rank partial correlation was used. In this multivariate analysis, a high admission blood glucose level tended to be associated with poor neurological outcome (rs = −0.16, n = 142, p = 0.06). The association between high median blood glucose levels over 24 h and poor neurological outcome was strong and statistically significant (rs = −0.2, n = 145, p = 0.015). High blood glucose concentrations occurring over the first 24 h after cardiac arrest have deleterious effects on functional neurological recovery. Whether cardiac arrest survivors might benefit from reduction of blood glucose levels needs further investigation.