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J Korean Soc Emerg Med > Volume 22(2); 2011 > Article
Journal of The Korean Society of Emergency Medicine 2011;22(2): 142-150.
Serial Measured Glucose Level and Neurological Outcome in Out of Hospital Cardiac Arrest Survivors Who Received Therapeutic Hypothermia
Jee Yong Jang, Yong Su Lim, Hyuk Jun Yang, Won Bin Park, Sung Youl Hyun, Jin Sung Cho, Jin Joo Kim, Mi Jin Lee
1Department of Emergency Medicine, School of Medicine, Gachon University, Incheon, Korea. yongem@gilhospital.com
2Department of Emergency Medicine, College of Medicine, Konyang University, Daejeon, Korea.
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.
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.
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)
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.
Key words: Heart arrest, Cardiopulmonary resuscitation, Glucose, Hyperglycemia, Hypothermia
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