title: Blood glucose level and outcome after cardiac arrest: insights from a large registry in the hypothermia era.
abstract: BACKGROUND
  The influence of blood glucose (BG) level during the post-resuscitation period after out-of-hospital cardiac arrest (OHCA) is still debated. To evaluate the relationship between blood glucose level and outcome, we included the median glycemia and its maximal amplitude over the first 48 h following ICU admission in an analysis of outcome predictors.
  
  
  METHODS
  We conducted a database study in a cardiac arrest center in Paris, France. Between 2006 and 2010, we included 381 patients who were all resuscitated from an OHCA. A moderate glycemic control was applied in all patients. The median glycemia and the largest change over the first 48 h were included in a multivariate analysis that was performed to determine parameters associated with a favorable outcome.
  
  
  RESULTS
  Of the 381 patients, 136 (36 %) had a favorable outcome (CPC 1-2). Median BG level was 7.6 mmol/L (6.3-9.8) in patients with a favorable outcome compared to 9.0 mmol/L (IQR 7.1-10.6) for patients with an unfavorable outcome (p < 0.01). Median BG level variation was 7.1 (4.2-11) and 9.6 (5.9-13.6) mmol/L in patients with and without a favorable outcome, respectively (p < 0.01). In multivariate analysis, an increased median BG level over the first 48 h was found to be an independent predictor of poor issue [OR = 0.43; 95 % CI (0.24-0.78), p = 0.006]. Finally a progressive increase in median BG level was associated with a progressive increase in the proportion of patients with a poor outcome.
  
  
  CONCLUSIONS
  We observed a relationship between high blood glucose level and outcome after cardiac arrest. These results suggest the need to test a strategy combining both control of glycemia and minimization of glycemic variations for its ability to improve post-resuscitation care.
authors.affiliation: Medical Intensive Care Unit, Cochin University Hospital, Assistance Publique-Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014, Paris, France, daviaudfabrice@gmail.com.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Daviaud
authors.forename: Florence
authors.initials: F
authors.lastname: Dumas
authors.forename: Nadège
authors.initials: N
authors.lastname: Demars
authors.forename: Guillaume
authors.initials: G
authors.lastname: Geri
authors.forename: Adrien
authors.initials: A
authors.lastname: Bouglé
authors.forename: Tristan
authors.initials: T
authors.lastname: Morichau-Beauchant
authors.forename: Yên-Lan
authors.initials: YL
authors.lastname: Nguyen
authors.forename: Wulfran
authors.initials: W
authors.lastname: Bougouin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Pène
authors.forename: Julien
authors.initials: J
authors.lastname: Charpentier
authors.forename: Alain
authors.initials: A
authors.lastname: Cariou
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood* / Q000628:therapy*; D012042:Registries; D012151:Resuscitation; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose