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Complete Neurologic Recovery From Extreme Hypoglycemia Secondary to Cardiogenic Liver Failure: A Case Report
Yafen Liang1, Jeremy M Bennett, Douglas B Coursin
1From the *Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee; and †Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Abstract:
Cardiogenic shock from acute severe mitral valve regurgitation can cause acute liver failure due to hypoperfusion. Impaired liver glycogenesis can then lead to profound hypoglycemia. The time frame for restoring normoglycemia without neurologic sequelae is not clearly established in humans. Thus, the clinical decision to provide further resuscitation in the setting of extreme hypoglycemia mainly depends on the patient's overall clinical condition, provider opinion, and/or institutional practice. Here, we report a case where the patient made complete neurologic recovery from extreme hypoglycemia (<5 mg/dL by central laboratory testing) secondary to acute cardiogenic shock and liver failure.
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