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Critical Care
Published in: Critical Care 1/2015

Open Access 01-12-2015 | Research

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

Authors: Teng J Peng, Lars W Andersen, Brian Z Saindon, Tyler A Giberson, Won Young Kim, Katherine Berg, Victor Novack, Michael W Donnino, for the American Heart Association’s Get With The Guidelines®-Resuscitation Investigators

Published in: Critical Care | Issue 1/2015

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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.
Appendix
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Metadata
Title
The administration of dextrose during in-hospital cardiac arrest is associated with increased mortality and neurologic morbidity
Authors
Teng J Peng
Lars W Andersen
Brian Z Saindon
Tyler A Giberson
Won Young Kim
Katherine Berg
Victor Novack
Michael W Donnino
for the American Heart Association’s Get With The Guidelines®-Resuscitation Investigators
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2015
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-015-0867-z

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