Abstract 176: Early Hyperglycemia Following Resuscitation From Cardiac Arrest Does Not Affect 72 Hour Neurologic Outcome in the Swine Model
Background: Hyperglycemia is common following resuscitation from cardiac arrest and has been shown to be a predictor of neurologic outcome in retrospective studies. The purpose of this study was to evaluate neurologic outcome and early post-arrest hyperglycemia in a swine cardiac arrest model.
Methods: Electrically-induced ventricular fibrillation cardiac arrest was induced in 22 anesthetized and instrumented swine. After 7 min, CPR and advanced cardiac life support was initiated. Twenty-one animals were resuscitated and serum glucose was measured at intervals for 60 min post-arrest. Animals were observed for 72 hours and neurologic score determined at 24 hr intervals.
Results: 10 animals demonstrated a peak serum glucose ≥ 226 mg/dl during the initial 60 min post-arrest. Neurologic scores at 72 hrs in these animals (mean score = 0, mean overall performance category = 1) was the same as that in animals with a serum glucose < 226 mg/dl. Plasma glucose levels are shown in the figure. End-tidal CO2 measured during CPR, time to restoration of spontaneous circulation, and epinephrine dose were not significantly different between animals with a peak glucose ≥ 226 mg/dl and those with lesser values.
Conclusions: This study suggests that early hyperglycemia is common following a period of global ischemia and resuscitation, but hyperglycemia alone does not have a predictive role in post-arrest neurologic function. This issue merits closer study in humans, given recent failures of tight glucose control to improve outcomes in other critical care settings.
- © 2010 by American Heart Association, Inc.