Blood glucose and neurologic outcome with global brain ischemia
作者:
Jay S. MD Steingrub,
Diane J. PhD Mundt,
期刊:
Critical Care Medicine
(OVID Available online 1996)
卷期:
Volume 24,
issue 5
页码: 802-806
ISSN:0090-3493
年代: 1996
出版商: OVID
数据来源: OVID
摘要:
ObjectiveTo investigate the relationship between neurologic outcome and blood glucose concentrations in survivors of cardiopulmonary arrest.DesignRetrospective case series chart review.SettingAdult multidisciplinary intensive care unit (ICU) of a tertiary referral medical center.SubjectsConsecutive patients over a 12-month period surviving cardiopulmonary resuscitation (CPR).InterventionsVariables that were examined that could affect the relationship between the circulating glucose concentration and neurologic outcome included: location of arrest (inhospital/out-of-hospital), age, history of diabetes mellitus, duration of arrest, CPR duration, initial cardiac rhythm, and drugs administered during arrest. Cerebral recovery was evaluated by a 5-point outcome scale (Glasgow Pittsburgh Brain Stem Score) on ICU admission, and 24 and 48 hrs after ICU admission.Measurements and Main ResultsObservations were made on 85 patients, of whom 67% had inpatient CPR and 33% received out-of-hospital CPR. The duration of arrest of 66 (78%) patients was less than 5 mins. Mean CPR duration was 13.7 mins. Twenty-one percent of patients had diabetes. The mean blood glucose concentration post-CPR (n equals 80) was 272 mg/dL (15.1 mmol/L). A statistically significant association was shown between high glucose concentration post-CPR and severe cerebral outcome among a small subset of patients with CPR lasting more than 5 mins.ConclusionsThe present study does not support an association between the concentration of glucose post-CPR and neurologic outcome. The previously reported causal relationship between hyperglycemia and neurologic prognosis may be an epiphenomenon of the severity of global cerebral ischemia in humans.(Crit Care Med 1996; 24:802-806)
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