Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33 degrees C and 36 degrees C

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064165%3A_____%2F17%3A10364179" target="_blank" >RIV/00064165:_____/17:10364179 - isvavai.cz</a>

Result on the web

<a href="http://dx.doi.org/10.1097/CCM.0000000000002367" target="_blank" >http://dx.doi.org/10.1097/CCM.0000000000002367</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1097/CCM.0000000000002367" target="_blank" >10.1097/CCM.0000000000002367</a>

Result language

angličtina

Original language name

Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33 degrees C and 36 degrees C

Original language description

Objectives: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes of patients randomized to targeted temperature management at 33 degrees C or 36 degrees C after cardiac arrest. Design: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as &quot;Cerebral Performance Category.&quot; Setting: Thirty-six sites in Europe and Australia. Patients: All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. Interventions: Targeted temperature management at 33 degrees C or 36 degrees C. Measurements and Main Results: Nonparametric tests as well as multiple logistic regression and mixed effects logistic regression models were used. Median glucose concentrations on hospital admission differed significantly between Cerebral Performance Category outcomes (p &lt; 0.0001). Hyper-and hypoglycemia were associated with poor neurologic outcome (p = 0.001 and p = 0.054). In the multiple logistic regression models, the median glycemic level was an independent predictor of poor Cerebral Performance Category (Cerebral Performance Category, 3-5) with an odds ratio (OR) of 1.13 in the adjusted model (p = 0.008; 95% CI, 1.03-1.24). It was also a predictor in the mixed model, which served as a sensitivity analysis to adjust for the multiple time points. The proportion of hyperglycemia was higher in the 33 degrees C group compared with the 36 degrees C group. Conclusion: Higher blood glucose levels at admission and during the first 36 hours, and higher glycemic variability, were associated with poor neurologic outcome and death. More patients in the 33 degrees C treatment arm had hyperglycemia.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Publication year

2017

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Critical Care Medicine

ISSN

0090-3493

e-ISSN

—

Volume of the periodical

45

Issue of the periodical within the volume

8

Country of publishing house

US - UNITED STATES

Number of pages

7

Pages from-to

1337-1343

UT code for WoS article

000405469600032

EID of the result in the Scopus database

2-s2.0-85023754773