Related Experiment Video

Updated: Jul 11, 2026

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
05:36

Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine

Published on: January 30, 2020

Strict versus moderate glucose control after resuscitation from ventricular fibrillation

Tuomas Oksanen1, Markus B Skrifvars, Tero Varpula

  • 1Helsinki University Hospital, Intensive Care Units, Jorvi Hospital, Turuntie 150, 02740 Espoo, Finland. tuomas.oksanen@hus.fi

Intensive Care Medicine
|October 12, 2007
PubMed

Insights

Strict glucose control in out-of-hospital cardiac arrest (OHCA) patients did not improve survival compared to moderate control. This study found no additional survival benefit, with similar mortality rates between groups.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Metabolic Disorders

Background:

  • Elevated blood glucose levels post-resuscitation are linked to poorer outcomes in out-of-hospital cardiac arrest (OHCA) patients.
  • Therapeutic hypothermia is a standard treatment for OHCA survivors.

Purpose of the Study:

  • To investigate whether strict glucose control using intensive insulin therapy improves outcomes in OHCA patients.
  • To compare the efficacy and safety of strict versus moderate glucose control in OHCA survivors.

Main Methods:

  • A randomized controlled trial was conducted in two university hospital intensive care units.
  • Ninety OHCA patients with ventricular fibrillation were randomized into strict (4-6 mmol/l) or moderate (6-8 mmol/l) glucose control groups.
  • Both groups received insulin infusion for 48 hours, with therapeutic hypothermia applied.

Main Results:

  • The strict glucose control group achieved better glycemic targets (71% vs 41%) with a median glucose of 5.0 mmol/l versus 6.4 mmol/l.
  • Moderate hypoglycemia occurred more frequently in the strict control group (18% vs 2%).
  • Thirty-day mortality rates were similar: 33% in the strict group and 35% in the moderate group (p=0.846).

Conclusions:

  • Strict glucose control (4-6 mmol/l) offers no additional survival benefit compared to moderate control (6-8 mmol/l) in OHCA patients treated with therapeutic hypothermia.
  • The study did not find improved survival with tighter glycemic management in this patient population.
  • Further research may be needed to define optimal glucose targets in OHCA patients.
Abstract

More Related Videos

Improving IV Insulin Administration in a Community Hospital12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Related Concept Videos

Glucose Homeostasis: Regulation of Blood Glucose01:02

Glucose Homeostasis: Regulation of Blood Glucose

Carbohydrates consumed through foods are converted into glucose, a crucial energy source for the body. In the prandial state, high blood glucose levels stimulate the secretion of insulin from the pancreas. Insulin inhibits hepatic glucose production and stimulates glucose uptake and metabolism by muscle and adipose tissue. The excess glucose is converted into glycogen and stored in the liver and muscles.
During fasting, when blood glucose levels are low, the pancreas secretes glucagon. it...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...
Dysrhythmias VI: Management of Dysrhythmias01:25

Dysrhythmias VI: Management of Dysrhythmias

Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
Cardiopulmonary Resuscitation IV: Pharmacological Management01:25

Cardiopulmonary Resuscitation IV: Pharmacological Management

Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...