Increased blood glucose variability during therapeutic hypothermia and outcome after cardiac arrest*

Cueni-Villoz, Nadine; Devigili, Alessandro; Delodder, Frederik; Cianferoni, Silvia; Feihl, François; Rossetti, Andrea O.; Eggimann, Philippe; Vincent, Jean‐Louis; Taccone, Fabio Silvio; Oddo, Mauro

doi:10.1097/ccm.0b013e31822572c9

Cited by 111 publications

(76 citation statements)

References 43 publications

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“…Furthermore, increased circulating catecholamines culminate in glycogenolysis, augmenting hyperglycemia. (10,11) The high frequency of hypothermia found in this study can be explained by not using hypothermia preventive measures in the pre-and intra-operative periods. All patients were covered with sterile drapes, leaving only the upper limbs, head and neck exposed.…”

Section: Discussionmentioning

confidence: 84%

“…However, no statistically significant results were found when comparing the occurrence of hypothermia and blood glucose values. (9,10) Hyperglycemia was the most frequent change in blood collections at the end of the surgical procedure. However, when correlating the occurrence of hyperglycemia at the end of surgery with hypothermia in the intraoperative period, the results found were not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

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Ocorrência e fatores associados à hipotermia no intraoperatório de cirurgias abdominais eletivas

et al. 2015

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Objective: To analyze the association between sociodemographic, clinical, surgical and environmental variables and the occurrence of hypothermia. Methods: Cross-sectional and analytical study conducted with 105 adult patients of both genders. The Pearson's coefficient showed a correlation between the patients' temperature with the duration of the anesthetic-surgical period, the stay in the operating room, and the average temperature in the operating room. Results: Of the 105 (100%) participants, 73 (69.5%) were female and 85 (81%) were adults. Hypothermia occurred in 98 (93.3%) patients. The average temperature was 36.1°C at the start of anesthetic procedure, with gradual decrease, reaching the average of 34°C. At the beginning of anesthetic induction, 29 (27.6%) patients had ear temperature <36 ° C and 60 minutes after induction, 78 (85.7%) patients were hypothermic, with an average temperature of 35.2 ° C. At the end of anesthesia, 93 (88.6%) patients had hypothermia with a minimum temperature of 31.4ºC. Conclusion: There was no significant correlation between the patient's average temperature and the average temperature of the operating room. The variables of female gender, combined anesthesia, duration of the procedure and the length of stay in the operating room were statistically significant to predict hypothermia. ResumoObjetivo: Analisar a associação entre variáveis sociodemográficas, clínicas, cirúrgicas e ambientais e ocorrência de hipotermia. Métodos: Estudo transversal e analítico, realizado com 105 pacientes adultos de ambos os sexos. O coeficiente de Pearson verificou a correlação entre a temperatura dos pacientes com a duração do período anestésico-cirúrgico, a permanência na sala de operações e a média de temperatura na sala cirúrgica. Resultados: A hipotermia ocorreu em 98 (93,3%) dos pacientes. No início do procedimento anestésico, a média de temperatura foi de 36,1°C, com diminuição gradativa atingindo 34°C de média. No início da indução anestésica, 29 (27,6%) pacientes apresentavam temperatura auricular <36°C e, 60 minutos após a indução, 78 (85,7%) pacientes encontravam-se hipotérmicos e com temperatura média de 35,2°C. Ao final do procedimento anestésico, 93 (88,6%) pacientes tiveram hipotermia com valor mínimo de 31,4ºC. Conclusão: Não houve correlação significativa entre a média de temperatura do paciente e as médias de temperatura da sala cirúrgica. As variáveis sexo feminino, anestesia combinada, duração do procedimento e o tempo de permanência na sala cirúrgica foram estatisticamente significantes para predizer hipotermia.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Ocorrência e fatores associados à hipotermia no intraoperatório de cirurgias abdominais eletivas

et al. 2015

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“…Although higher temperatures (33 0 C) are used during hypothermia treatment after out-ofhospital cardiac arrest in adults, hyperglycemia has been reported as an adverse effect 13 .…”

Section: Discussionmentioning

confidence: 99%

Persistent hyperglycemia in a neonate: Is it a complication of therapeutic hypothermia?

et al. 2017

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The aim of this report is to present a newborn with persistent hyperglycemia requiring insulin therapy as a possible complication of therapeutic hypothermia. A term appropriate for gestational age (AGA) female infant, was born by emergency cesarean section due to abruption of placenta and was resuscitated and intubated in the delivery room. Whole body cooling was initiated according to standard cooling criteria. The patient's blood glucose increased up to 250 mg/dl on a glucose perfusion rate of 6 mg/kg/min after the second day of cooling. Insulin therapy was started due to persistent hyperglycemia and continued for 17 days. As it has been reported in adults after therapeutic cooling, persistent hyperglycemia attributed to hypothermia can also complicate therapeutic hypothermia in neonates.

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“…Trzeciak et al, 31 Gaieski et al, 32 Sundgreen et al 33 Buunk et al, 35 Bisschops et al, 36 Kilgannon et al, 37 Diringer 38 Hachimi-Idrissi et al, 24 Bernard et al, 25 HACA, 26 Sundgreen et al 33 Finfer et al, 42 Cueni-Villoz et al 43 Laurent et al 34 Dumas et al, 39 O'Connor et al 41 …”

Section: Referencesmentioning

confidence: 99%

“…Very aggressive blood glucose management may be harmful; for example, in the NICE SUGAR trial, a blood glucose target of 180 mg/dL or less resulted in lower mortality than did a target of 81 to 108 mg/dL. 42 Blood glucose variability can occur during therapeutic hypothermia because of reduced glucose utilization, decreased endogenous insulin secretion, and increased resistance to insulin; reasonable control with insulin is recommended 43 (Table 3). …”

Section: Glucose Controlmentioning

confidence: 99%

From Door to Recovery: A Collaborative Approach to the Development of a Post–Cardiac Arrest Center

Williams

Calder²,

Cocchi³

et al. 2013

Critical Care Nurse

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Out-of-hospital cardiac arrest remains common and, despite advances in resuscitation practices, continues to carry a high mortality that may be influenced by several factors, including where a patient is cared for after the cardiac arrest. Implementing a post–cardiac arrest care guideline for survivors of out-of-hospital and in-hospital cardiac arrest involves a multidisciplinary approach with short-term and long-term strategies. Physician and nursing leaders must work in synergy to guide the implementation of an evidence-based plan of care. A collaborative approach was used at a hospital to develop processes, build consensus for protocols, and provide support to staff and teams. A joint approach has allowed the hospital to move from traditional silos of individual departmental care to a continuum of patient-focused management after cardiac arrest. This care coordination is initiated in the emergency department and follows the patient through to discharge.

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Increased blood glucose variability during therapeutic hypothermia and outcome after cardiac arrest*

Cited by 111 publications

References 43 publications

Ocorrência e fatores associados à hipotermia no intraoperatório de cirurgias abdominais eletivas

Ocorrência e fatores associados à hipotermia no intraoperatório de cirurgias abdominais eletivas

Persistent hyperglycemia in a neonate: Is it a complication of therapeutic hypothermia?

From Door to Recovery: A Collaborative Approach to the Development of a Post–Cardiac Arrest Center

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