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Hypoglycemic cardiac arrest and rapid return-of-spontaneous circulation (ROSC) with dextrose

Joan Rui Shan Fun1, Michael Yih Chong Chia1

  • 1Department of Emergency Medicine, Tan Tock Seng Hospital, Singapore.

The American Journal of Emergency Medicine
|May 29, 2020
PubMed

Insights

Hypoglycemia, a reversible cause of cardiac arrest, was previously in ACLS guidelines. This case highlights its importance in cardiac arrest patients, even if routine dextrose use is cautioned against.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Critical Care Medicine

Background:

  • Hypoglycemia was historically recognized as a reversible cause of cardiac arrest in ACLS guidelines.
  • Current guidelines do not routinely recommend dextrose administration for undifferentiated cardiac arrest due to potential harm.

Observation:

  • A case of return of spontaneous circulation following dextrose administration for confirmed hypoglycemia in a cardiac arrest patient is presented.
  • This observation challenges the blanket exclusion of hypoglycemia management in cardiac arrest scenarios.

Findings:

  • The patient achieved return of spontaneous circulation after dextrose was administered to correct documented hypoglycemia.
  • This suggests that in specific cases, addressing hypoglycemia can be crucial for resuscitation outcomes.

Implications:

  • Clinicians should maintain a high index of suspicion for hypoglycemia in cardiac arrest patients.
  • Targeted glucose level assessment and correction in cardiac arrest may be warranted in select cases, despite general guidelines against routine dextrose use.

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