title: Time to reach target glucose level and outcome after cardiac arrest patients treated with therapeutic hypothermia.
abstract: BACKGROUND
  Hyperglycemia after cardiac arrest is common and associated with unfavorable neurologic outcomes and mortality. This study tested the hypothesis that time to reach target blood glucose level is associated with the outcome of patients after cardiac arrest treated with therapeutic hypothermia (TH).
  
  
  METHODS
  Patients who were treated with TH after cardiac arrest and who had admission blood glucose levels higher than 180 mg/dL were included in this study. The arterial blood glucose target was set at 72 to 180 mg/dL using a written algorithm with a nurse-driven adjustment of the insulin infusion rate. The primary outcomes were patient survival at hospital discharge and favorable neurologic outcomes. Favorable neurologic outcomes were defined as Cerebral Performance Category scores of 1 and 2. Multivariate logistic regression analysis was performed with variables with various significance levels in univariate analysis.
  
  
  RESULTS
  One hundred three patients were included in this study. Patients were categorized into 3 groups. The mean patient age was 53 years, and 58% of the patients were male. Eighteen patients had a history of diabetes. Seventy-two patients (70%) survived, and 41 (40%) achieved favorable neurologic outcomes at the hospital discharge. Multivariate logistic analysis showed that early target achievement of blood glucose level within 4 hours was significantly associated with survival at hospital discharge and favorable neurologic outcomes.
  
  
  CONCLUSIONS
  The time to reach target glucose level was significantly associated with survival and favorable neurologic outcomes at hospital discharge in patients treated with TH after cardiac arrest.
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: emksh77@gmail.com.
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: emsky@catholic.ac.kr.
authors.forename: Kyu Nam
authors.initials: KN
authors.lastname: Park
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: emvic98@catholic.ac.kr.
authors.forename: Seung Pill
authors.initials: SP
authors.lastname: Choi
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: emart@catholic.ac.kr.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: hanjoon@catholic.ac.kr.
authors.forename: Han Joon
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: ohmytweety@catholic.ac.kr.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Oh
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: ycs1005@catholic.ac.kr.
authors.forename: Chun Song
authors.initials: CS
authors.lastname: Youn
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007036:Hypothermia, Induced; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D058687:Out-of-Hospital Cardiac Arrest / Q000150:complications / Q000401:mortality / Q000628:therapy*; D010351:Patient Discharge; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Heart arrest; Hyperglycemia; Hypothermia induced; Insulin; Mortality