Induced hypothermia after primary cardiac arrest (PCA) reduces post-ischemic reperfusion brain damage. At the Center for Intensive Internal Medicine (CIIM) of the LjubljanaMedicalCenter, it has been in routine use since the beginning of 2004. Patients who have undergone induced hypothermia to date, have exhibited better survival rates and neurological outcomes, which is in agreement with the results of foreign studies. After PCA, many patients have severe hyperglycemia with serum glucose levels above 11 mmol\/l. However, the effec\u00adtiveness of induced hypothermia in patients with severe hyperglycemia after PCA remains unresearched.\u00a0The purpose of this study was to evaluate survival, neurological outcomes and compli\u00adcations of treatment in patients with hyperglycemia after PCA who were treated with induced hypothermia, with respect to serum glucose levels, and to compare them with results obtained before this method was introduced. Another aim was to objectify the effectiveness of treat\u00adment for hyperglycemia in patients after PCA treated at the CIIM.\u00a0The study included patients who were treated at the CIIM after PCA during the period from 1 January 2001 to 31 December 2005 and who fulfilled the criteria for treatment with induced hypothermia. The test group consisted of cooled patients, while the control group included noncooled patients, i. e. those from the period before the introduction of cooling. Serum glucose levels were compared between the two groups and within each of the groups the relationship between serum glucose levels, and survival rates and neurological outcomes was studied. In patients with severe hyperglycemia after PCA, survival rates, neurological outcomes, complications of treatment and effectiveness of insulin therapy were compared between the cooled and the noncooled group.A total of 159 patients were included in the study, of whom 85 were cooled and 74 were not. Among the cooled patients, there were 57 patients with severe hyperglycemia after PCA and among the noncooled there were 54. For cooled patients, an association between lower serum glucose levels upon admission and during the first four days of treatment, and favourable long-term neurological outcomes (P < 0.03) was proven. However, the groups of cooled and noncooled patients who had severe hyperglycemia after PCA showed no differences in sur\u00advival rates and long-term neurological outcomes or the complications of treatment. The cooled group had higher average values of serum glucose during cooling at the CIIM (P = 0.03), and lower ones were observed when cooling was stopped (P < 0.05). The cooled group also received higher daily doses of insulin (P< 0.001).\u00a0Patients treated with induced hypothermia after PCA who have lower morning serum glucose levels, also have better survival rates and neurological outcomes, while induced hypothermia does not improve the survival rates and neurological outcomes in patients with severe hyperglycemia after PCA. Patients treated with induced hypothermia after PCA have higher morning serum glucose levels during cooling at the CIIM than those who are not cooled.<\/p>\n","protected":false},"excerpt":{"rendered":"
Induced hypothermia after primary cardiac arrest (PCA) reduces post-ischemic reperfusion brain damage. At the Center for Intensive Internal Medicine (CIIM) of the LjubljanaMedicalCenter, it has been in routine use since the beginning of 2004. Patients who have undergone induced hypothermia to date, have exhibited better survival rates and neurological outcomes, which is in agreement with […]<\/p>\n","protected":false},"author":28,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_links_to":"","_links_to_target":""},"categories":[372,407,426],"tags":[],"class_list":["post-5047","post","type-post","status-publish","format-standard","hentry","category-4-2006-archive","category-clinical-research-paper","category-internal-medicine"],"acf":[],"yoast_head":"\n