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Association between Blood Glucose Levels the Day after Targeted Temperature Initiation and Outcome in Traumatic Brain Injury: A Post-Hoc Analysis of the B-HYPO Study.
- Source :
-
Journal of Neurotrauma . Mar2017, Vol. 34 Issue 5, p987-995. 9p. - Publication Year :
- 2017
-
Abstract
- We investigated associations between blood glucose levels and clinical outcomes in participants of the multi-center randomized controlled Brain-Hypothermia (B-HYPO) study. Patients with severe traumatic brain injury (TBI, Glasgow Coma Scale 4-8) were assigned to therapeutic hypothermia (TH, 32-34°C, n = 98) or fever control (35.5-37.0°C, n = 50) groups. TH patients were cooled as soon as possible for ≥72 h and rewarmed at a rate of <1°C/d. We recorded blood glucose (BG) levels on days 0, 1, and 3 after treatment initiation, and day 1 after rewarming. The Glasgow Outcome Scale was assessed at 6 months. Median BG levels decreased from day 0 to day 1 (163 vs. 132 mg/dL, p = 0.0062) in the fever control group. In contrast, a decrease was observed from day 1 to day 3 (157.5 vs. 126 mg/dL, p < 0.001) in the TH group. Day 1 BG was higher in the TH group compared with the fever control group ( p = 0.0252). At day 0, BG levels were higher in non-survivors compared with survivors across all patients ( p = 0.0035), the TH group ( p = 0.0125), and the non-surgical group ( p = 0.0236). Higher day 1 BG levels were observed in non-survivors compared with survivors across all patients ( p = 0.0071), the fever control group ( p = 0.0495), and the surgical group ( p = 0.0364). In the TH group, the initial stress hyperglycemia was sustained the next day after TH induction. Day 1 BG predicted outcome in TBI patients with TH and fever control. Our findings indicate the significance of BG control particularly during TH treatment. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08977151
- Volume :
- 34
- Issue :
- 5
- Database :
- Academic Search Index
- Journal :
- Journal of Neurotrauma
- Publication Type :
- Academic Journal
- Accession number :
- 121467536
- Full Text :
- https://doi.org/10.1089/neu.2016.4662