Author/Editor		Grošelj, Urh; Kavčič, Marko
Title		Nadzorovana podhladitev po srčnem zastoju pri bolnikih s hiperglikemijo
Translated title		Induced hypothermia after cardiac arrest in hyperglicaemic patients
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 45, št. 4
Publication year		2006
Volume		str. 363-82
Language		slo
Abstract		Induced hypothermia after primary cardiac arrest (PCA) reduces post-ischemic reperfusion brain damage. At the Center for Intensive Internal Medicine (CIIM) of the Ljubljana Medical Center, it has been in routine use since the beginning of 2004. Patients who have undergone induced hypothermia to date, have exhibited better survival rates and neurological outcomes, which is in agreement with the results of foreign studies. After PCA, many patients have severe hyperglycemia with serum glucose levels above 11 mmol/1. However, the effectiveness of induced hypothermia in patients with severe hyperglycemia after PCA remains unresearched. The purpose of this study was to evaluate survival, neurological outcomes and complications of treatment in patients with hyperglycemia after PCA who were treated with induced hypothermia, with respect to serum glucose levels, and to compare them with results obtained before this method was introduced. Another aim was to objectify the effectiveness of treatment for hyperglycemia in patients after PCA treated at the CIIM. The study included patients who were treated at the CIIM after PCA during the period from 1 January 2001 to 31 December 2005 and who fulfilled the criteria for treatment with induced hypothermia. The test group consisted of cooled patients, while the control group included noncooled patients, i. e. those from the period before the introduction of cooling. Serum glucose levels were compared between the two groups and within each of the groups the relationship between serum glucose levels, and survival rates and neurological outcomes was studied. In patients with severe hyperglycemia after PCA, survival rates, neurological outcomes, complications of treatment and effectiveness of insulin therapy were compared between the cooled and the noncooled group. (Abstract truncated at 2000 characters)
Summary		Nadzorovana podhladitev po primarnem srčnem zastoju (PSZ) zmanjšuje ishemično in reperfuzijsko poškodbo možganov. V Centru za intenzivno interno medicino Kliničnega centra Ljubljana (CIIM) je v rutinski uporabi od začetka leta 2004. Pri doslej hlajenih bolnikih smo skladno z rezultati tujih raziskav ugotovili boljše preživetje in nevrološki izid. Mnogo bolnikov po PSZ ima hudo hiperglikemijo s koncentracijo serumske glukoze nad 11 mmol/L. Kljub temu pa je še neraziskana učinkovitost nadzorovane podhladitve pri bolnikih s hudo hiperglikemijo po PSZ. Namen naše raziskave je ovrednotiti preživetje, nevrološki izid in zaplete pri bolnikih s hiperglikemijo po PSZ, z ozirom na koncentracijo serumske glukoze. Primerjati želimo bolnike pred in po uvedbi metode nadzorovanega podhlajevanja. Objektivizirati želimo tudi učinkovitost zdravljenja hiperglikemije pri bolnikih po PSZ, na CIIM. V raziskavo smo vključili bolnike, ki so se od 1.1. 2001 do 31.12. 2005 zdravili na CIIM po PSZ in so ustrezali kriterijem za zdravljenje z nadzorovano podhladitvijo. Testno skupino so sestavljali hlajeni bolniki, kontrolno skupino pa nehlajeni bolniki (iz obdobja pred uvedbo hlajenja). Primerjali smo koncentracije serumske glukoze in v vsaki od skupin ugotavljali povezavo med koncentracijami serumske glukoze in preživetjem ter nevrološkim izidom. Pri bolnikih s hudo hiperglikemijo po PSZ smo primerjali preživetje, nevrološki izid, zaplete zdravljenja in učinkovitost inzulinskega zdravljenja med hlajeno in nehlajeno skupino. (Izvleček skrajšan na 2000 znakov)
Descriptors		HEART ARREST HYPERGLYCEMIA HYPOTHERMIA, INDUCED RESUSCITATION TREATMENT OUTCOME