Increase in plasma glucagon, a factor in hyperglycemia, is related to neurological outcome in postcardiac-arrest patients.
OBJECTIVE
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.
Oshima
Chiyomi
C
Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1 Minamikogushi, Ube, Yamaguchi, Japan.
Kaneko
Tadashi
T
Tsuruta
Ryosuke
R
Oda
Yasutaka
Y
Miyauchi
Takashi
T
Fujita
Motoki
M
Kawamura
Yoshikatsu
Y
Kasaoka
Shunji
S
Maekawa
Tsuyoshi
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005934:Glucagon / Q000097:blood*; D006323:Heart Arrest / Q000097:blood* / Q000150:complications*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
D005934:Glucagon