[Glucose--friend or foe of the hypoxic-ischemic brain?]

Glucose is the most important cerebral fuel. During severe hypoxia-ischemia anaerobic glycolysis may partly replace oxidative phosphorylation as a source of energy, and in this situation high glucose levels may improve energy production. Despite this, it has been shown convincingly that, in adult animals, a high glucose level before global, cerebral ischemia increases the damage. In newborn animals the results are species-dependent. The importance of postischemic glucose levels is more uncertain. Few clinical intervention studies have been carried out, but some tentative guidelines can nevertheless be suggested.