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Strict versus moderate glucose control after resuscitation from ventricular fibrillation
- Source :
- Intensive Care Medicine. December, 2007, Vol. 33 Issue 12, p2093, 8 p.
- Publication Year :
- 2007
-
Abstract
- Objective: Elevated blood glucose is associated with poor outcome in patients resuscitated from out-of-hospital cardiac arrest (OHCA). Our aim was to determine whether strict glucose control with intensive insulin treatment improves outcome of OHCA patients. Design: A randomized, controlled trial. Setting: Two university hospital intensive care units. Patients: Ninety patients resuscitated from OHCA with ventricular fibrillation detected as the initial rhythm were treated with therapeutic hypothermia. Interventions: Patients were randomized into two treatment groups: a strict glucose control group (SGC group), with a blood glucose target of 4-6 mmol/l, or a moderate glucose control group (MGC group), with a blood glucose target of 6-8 mmol/l. Both groups were treated with insulin infusion for 48 h, because a control group with no treatment was considered unethical. Measurements and results: Baseline data were similar in both groups. In the SGC group 71% of the glucose measurements were within the target range compared with 41% in the MGC group. Median glucose was 5.0 mmol/l in the SGC group and 6.4 mmol/l in the MGC group. The occurrence of moderate hypoglycemic episodes was 18% in the SGC group and 2% in the MGC group (p = 0.008). No episodes of severe hypoglycemia occurred. Mortality by day 30 was 33% in the SGC group and 35% in the MGC group (p = 0.846); the difference was 2% (95% CI -18% to +22%). Conclusions: We found no additional survival benefit from strict glucose control compared with moderate glucose control with a target between 6 and 8 mmol/l in OHCA patients. Keywords Randomized controlled trial * Resuscitation * Glucose * Hypothermia * Mortality * Enolase<br />Introduction One major aim of intensive care after cardiac arrest is to alleviate the hypoxic-ischemic brain injury that evolves during the reperfusion period. Several post-resuscitation factors, such as low blood [...]
Details
- Language :
- English
- ISSN :
- 03424642
- Volume :
- 33
- Issue :
- 12
- Database :
- Gale General OneFile
- Journal :
- Intensive Care Medicine
- Publication Type :
- Academic Journal
- Accession number :
- edsgcl.171791981
- Full Text :
- https://doi.org/10.1007/s00134-007-0876-8