Does Early Postresuscitation Stress Hyperglycemia Affect 72 Hour Neurologic Outcome? Preliminary Observations In The Swine Model

Background—Hyperglycemia is common in the early period 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—Ten animals demonstrated a peak plasma 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. 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