Increase in plasma glucagon, a factor in hyperglycemia, is related to neurological outcome in postcardiac-arrest patients

Abstract: Aim of the study: In postcardiac-arrest (PCA) patients, hyperglycemia is a factor reflecting an unfavorable outcome, and might be caused by the inflammation and stress of “sepsis-like” syndrome. In this study, plasma glucagon, a representative glycogenolytic and gluconeogenic hormone, was measured and assessed the correlation for neurological outcome in PCA patients. Methods: This study was a retrospective, single-medical-center analysis, conducted in the intensive care unit of a university hospital. Twenty-four sequential PCA patients were included. Plasma samples were collected from the patients on days 1, 2, and 3 after the return of spontaneous circulation (ROSC). Glucagon was compared in patients with favorable and unfavorable neurological outcomes. Results: At all time points, plasma glucagon was significantly higher in patients with an unfavorable outcome (P <0.05). Glucagon on day 1 had remarkable sensitivity (88.2%) and specificity (85.8%) as an indicator of outcome, and correlated with the collapse–ROSC interval, the start of cardiopulmonary resuscitation (CPR)–ROSC interval, and the epinephrine dose during CPR. Conclusions: Plasma glucagon reflects unfavorable outcomes in PCA patients, and might be related to ischemic and reperfusion stress. [Copyright &y& Elsevier]