In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 12 ( 2022-12-30), p. e0279776-
Abstract:
We investigated the association of insulin administration method with the achievement of mean glucose ≤ 180 mg/dL and neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors who had hyperglycemia after the return of spontaneous circulation. From a multicenter prospective registry, we extracted the data of adult OHCA survivors who underwent targeted temperature management (TTM) between 2015 and 2018. Blood glucose levels every 4 h after initiating TTM were obtained for 72 h. We divided insulin administration methods into three categories: subcutaneous (SQI), intravenous bolus (IBI), and continuous intravenous (CII). We calculated the mean glucose and standard deviation (SD) of glucose. The primary outcome was the achievement of mean glucose ≤ 180 mg/dL. The secondary outcomes were the 6-month neurological outcome based on the Cerebral Performance Category (CPC) scale (good, CPC 1–2; poor, CPC 3–5), mean glucose, and SD of glucose. Of the 549 patients, 296 (53.9%) achieved mean glucose ≤ 180 mg/dL, and 438 (79.8%) had poor neurological outcomes, 134 (24.4%), 132 (24.0), and 283 (51.5%) were in the SQI, IBI, and CII groups, respectively. The SQI (adjusted odds ratio [aOR], 0.848; 95% confidence intervals [CIs] , 0.493–1.461) and IBI (aOR, 0.673; 95% CIs, 0.415–1.091) groups were not associated with mean glucose ≤ 180 mg/dL and the SQI (aOR, 0.660; 95% CIs, 0.335–1.301) and IBI (aOR, 1.757; 95% CIs, 0.867–3.560) groups were not associated with poor neurological outcomes compared to the CII group. The CII (168 mg/dL [147–202]) group had the lowest mean glucose than the SQI (181 mg/dL [156–218] ) and IBI (184 mg/dL [162–216]) groups. The CII (45.0[33.9–63.5] ) group had a lower SD of glucose than the IBI (50.8 [39.1–72.0]) group. The insulin administration method was not associated with achieving mean glucose ≤ 180 mg/dL and 6-month neurological outcomes.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0279776
DOI:
10.1371/journal.pone.0279776.g001
DOI:
10.1371/journal.pone.0279776.t001
DOI:
10.1371/journal.pone.0279776.t002
DOI:
10.1371/journal.pone.0279776.t003
DOI:
10.1371/journal.pone.0279776.t004
DOI:
10.1371/journal.pone.0279776.t005
DOI:
10.1371/journal.pone.0279776.t006
DOI:
10.1371/journal.pone.0279776.t007
DOI:
10.1371/journal.pone.0279776.t008
DOI:
10.1371/journal.pone.0279776.s001
DOI:
10.1371/journal.pone.0279776.s002
DOI:
10.1371/journal.pone.0279776.s003
DOI:
10.1371/journal.pone.0279776.r001
DOI:
10.1371/journal.pone.0279776.r002
DOI:
10.1371/journal.pone.0279776.r003
DOI:
10.1371/journal.pone.0279776.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3