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Crit Care. 2015 Apr 10;19:160. doi: 10.1186/s13054-015-0867-z.

The administration of dextrose during in-hospital cardiac arrest is associated with increased mortality and neurologic morbidity.

Author information

1
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. teng@bu.edu.
2
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. lwanders@bidmc.harvard.edu.
3
Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark. lwanders@bidmc.harvard.edu.
4
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. bsaindon@bu.edu.
5
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. tyler.a.giberson.med@dartmouth.edu.
6
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. wonpia@yahoo.co.kr.
7
Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. kberg@bidmc.harvard.edu.
8
Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. victorno@clalit.org.il.
9
Clinical Research Center, Soroka University Medical Centers, Beer-Shave, Israel. victorno@clalit.org.il.
10
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, One Deaconess Road, W/CC 2, Boston, MA, 02215, USA. mdonnino@bidmc.harvard.edu.
11
Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. mdonnino@bidmc.harvard.edu.

Abstract

INTRODUCTION:

Dextrose may be used during cardiac arrest resuscitation to prevent or reverse hypoglycemia. However, the incidence of dextrose administration during cardiac arrest and the association of dextrose administration with survival and other outcomes are unknown.

METHODS:

We used the Get With The Guidelines®-Resuscitation national registry to identify adult patients with an in-hospital cardiac arrest between the years 2000 and 2010. To assess the adjusted effects of dextrose administration on survival, we used multivariable regression models with adjustment for multiple patient, event, and hospital characteristics. We performed additional analyses to examine the effects of dextrose on neurological outcome and return of spontaneous circulation.

RESULTS:

Among the 100,029 patients included in our study, 4,189 (4.2%) received dextrose during cardiac arrest resuscitation. The rate of dextrose administration increased during the study period (odds ratio 1.11, 95% confidence interval (CI) 1.09-1.12 per year, P <0.001). Patients who received dextrose during resuscitation had lower rates of survival compared with patients who did not receive dextrose (relative risk 0.88, 95% CI 0.80-0.98, P = 0.02). Administration of dextrose was associated with worse neurological outcome (relative risk 0.88, 95% CI 0.79-0.99, P = 0.03) but an increased chance of return of spontaneous circulation (relative risk 1.07, 95% CI 1.04-1.10, P <0.001).

CONCLUSIONS:

In this dataset, the administration of dextrose during resuscitation in patients with in-hospital cardiac arrest was found to be associated with a significantly decreased chance of survival and a decreased chance of good neurological outcome.

PMID:
25887120
PMCID:
PMC4415309
DOI:
10.1186/s13054-015-0867-z
[Indexed for MEDLINE]
Free PMC Article

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