Hyperglycemia

I n global ischemia from CA, elevated serum glucose has been associated with unfavorable outcome (76,77). Serum glucose elevation is believed to be a marker of the severity of injury. In a series of 145 nondiabetic CA patients, a strong association was found between high median blood glucose levels over 24 hours and poor neurologic outcome (78).

Toward avoidance of potential neurologic injury, American Heart Association guidelines state that during cardiopulmonary resuscitation, drugs should be administered in nonglucose-containing solutions (79). In the absence of controlled human trials that report any benefit of glucose control in stroke and global cerebral ischemia, some insight might be gleaned from the general critical care literature. A randomized, controlled study of general ICU patients with primarily systemic pathology showed that tight control of serum glucose (80 and 110 mg/dL) facilitated reduction of overall mortality by approximately 50% (80). Therefore, glucose monitoring with tight control might prove beneficial to post CA patients.

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