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      치료적 저체온요법을 시행한 병원전 심정지 환자에서 연속 측정한 혈당치와 신경학적 예후 = Serial Measured Glucose Level and Neurological Outcome in Out of Hospital Cardiac Arrest Survivors Who Received Therapeutic Hypothermia

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      https://www.riss.kr/link?id=A104607690

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      다국어 초록 (Multilingual Abstract)

      Purpose: In patients resuscitated from out-of-hospital cardiac arrest (OHCA), the influences of serial serum glucose and variability on neurological outcome are not well understood.
      We investigated the influence of serum glucose and variability on neurological outcome in OHCA survivors.
      Methods: Records of 105 OHCA survivors who received therapeutic hypothermia (TH) between April, 2007 and January, 2010 were retrospectively reviewed. By neurological prognosis at 6 months after restoration of spontaneous circulation, patients were divided to two groups based on cerebral performance category (CPC) score; 1-2 (good)and 3-5 (poor). The serial measured glucose level and glucose variability during 72 hours were compared between the groups.
      Results: The poor CPC group had statistically higher mean, median and maximum glucose level, but not minimal glucose, compared to the good CPC group. The poor CPC group also comparatively displayed higher standard deviation and time-glucose variability index (TGVI) of glucose level during 72 hours. Multiple logistic regression demonstrated that increased TGVI was significantly associated with poor neurological outcome (odds ratio 1.304, 95% confidence interval 1.078-1.578)Conclusion: Serial glucose level and variability are strongly related with neurological outcome in post-resuscitated patients who received TH after OHCA. Further randomized controlled studies are needed
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      Purpose: In patients resuscitated from out-of-hospital cardiac arrest (OHCA), the influences of serial serum glucose and variability on neurological outcome are not well understood. We investigated the influence of serum glucose and variability on neu...

      Purpose: In patients resuscitated from out-of-hospital cardiac arrest (OHCA), the influences of serial serum glucose and variability on neurological outcome are not well understood.
      We investigated the influence of serum glucose and variability on neurological outcome in OHCA survivors.
      Methods: Records of 105 OHCA survivors who received therapeutic hypothermia (TH) between April, 2007 and January, 2010 were retrospectively reviewed. By neurological prognosis at 6 months after restoration of spontaneous circulation, patients were divided to two groups based on cerebral performance category (CPC) score; 1-2 (good)and 3-5 (poor). The serial measured glucose level and glucose variability during 72 hours were compared between the groups.
      Results: The poor CPC group had statistically higher mean, median and maximum glucose level, but not minimal glucose, compared to the good CPC group. The poor CPC group also comparatively displayed higher standard deviation and time-glucose variability index (TGVI) of glucose level during 72 hours. Multiple logistic regression demonstrated that increased TGVI was significantly associated with poor neurological outcome (odds ratio 1.304, 95% confidence interval 1.078-1.578)Conclusion: Serial glucose level and variability are strongly related with neurological outcome in post-resuscitated patients who received TH after OHCA. Further randomized controlled studies are needed

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      참고문헌 (Reference)

      1 Egi M, "Variability of blood glucose concentration and short-termmortality in critically ill patients" 105 : 244-252, 2006

      2 Bagshaw SM, "The impact of early hypoglycemia and bloodglucose variability on outcome in critical illness" 13 : 91-, 2009

      3 Dillinger RP, "Survival Sepsis Campaign guidelines formanagement of severe sepsis and septic shock" 32 : 858-873, 2004

      4 Oksanen T, "Strict versus moderate glucose controlafter resuscitation from ventricular fibrillation" 33 : 2093-2100, 2007

      5 Losert H, "Strict normoglycaemic blood glucoselevels in the therapeutic management of patients within12h after cardiac arrest might not be necessary" 76 : 214-220, 2008

      6 Pell JP, "Presentation, management, and outcome of out ofhospital cardiopulmonary arrest: comparison by underlyingaetiology" 89 : 893-842, 2003

      7 Nolan JP, "Post-cardiac arrest syndrome: epidemiology,pathophysiology, treatment, and prognostication. AScientific Statement from the International LiaisonCommittee on Resuscitation; the American HeartAssociation Emergency Cardiovascular Care Committee;the Council on Cardiovascular Surgery and Anesthesia;the Council on Cardiopulmonary, Perioperative, andCritical Care; the Council on Clinical Cardiology; theCouncil on Stroke" 79 : 350-379, 2008

      8 The Hypothermia After Cardiac Arrest Study Group, "Mildtherapeutic hypothermia to improve the neurologic outcomeafter cardiac arrest" 346 : 549-556, 2002

      9 Risso A, "Intermittent high glucose enhances apoptosis in humanumbilical vein endothelial cells in culture" 281 : 924-930, 2001

      10 Quagliaro L, "Intermittent high glucose enbances apoptosisrelated to oxidative stress in human umbilical veinendothelial cells: The role of protein kinase C and NAD(P)H-oxidase activation" 52 : 2795-2804, 2003

      1 Egi M, "Variability of blood glucose concentration and short-termmortality in critically ill patients" 105 : 244-252, 2006

      2 Bagshaw SM, "The impact of early hypoglycemia and bloodglucose variability on outcome in critical illness" 13 : 91-, 2009

      3 Dillinger RP, "Survival Sepsis Campaign guidelines formanagement of severe sepsis and septic shock" 32 : 858-873, 2004

      4 Oksanen T, "Strict versus moderate glucose controlafter resuscitation from ventricular fibrillation" 33 : 2093-2100, 2007

      5 Losert H, "Strict normoglycaemic blood glucoselevels in the therapeutic management of patients within12h after cardiac arrest might not be necessary" 76 : 214-220, 2008

      6 Pell JP, "Presentation, management, and outcome of out ofhospital cardiopulmonary arrest: comparison by underlyingaetiology" 89 : 893-842, 2003

      7 Nolan JP, "Post-cardiac arrest syndrome: epidemiology,pathophysiology, treatment, and prognostication. AScientific Statement from the International LiaisonCommittee on Resuscitation; the American HeartAssociation Emergency Cardiovascular Care Committee;the Council on Cardiovascular Surgery and Anesthesia;the Council on Cardiopulmonary, Perioperative, andCritical Care; the Council on Clinical Cardiology; theCouncil on Stroke" 79 : 350-379, 2008

      8 The Hypothermia After Cardiac Arrest Study Group, "Mildtherapeutic hypothermia to improve the neurologic outcomeafter cardiac arrest" 346 : 549-556, 2002

      9 Risso A, "Intermittent high glucose enhances apoptosis in humanumbilical vein endothelial cells in culture" 281 : 924-930, 2001

      10 Quagliaro L, "Intermittent high glucose enbances apoptosisrelated to oxidative stress in human umbilical veinendothelial cells: The role of protein kinase C and NAD(P)H-oxidase activation" 52 : 2795-2804, 2003

      11 The NICE-SUGAR Study Investigators, "Intensive versusconventional glucose control in critically ill patients" 360 : 1283-1297, 2009

      12 Arabi YM, "Intensive versus conventionalinsulin therapy: A randomized controlled trial inmedical and surgical critically ill patients" 36 : 3190-3197, 2008

      13 Van den Berghe G, "Intensive insulin therapy incritically ill patients" 345 : 1359-1367, 2001

      14 Brunknorst FM, "Intensive insulin therapy andpentastarch resuscitation in severe sepsis" 358 : 125-139, 2008

      15 Nolan JP, "Gupta V,Rowan K. Outcome following admission to UK intensivecare units after cardiac arrest: a secondary analysis of theICNARC Case Mix Programme Database" 62 : 1207-1216, 2007

      16 Krinsley JS, "Glycemic variability: a strong independentpredictor of mortality in critically ill patients" 36 : 3008-3013, 2008

      17 Hermanides J, "Glucose variability is associatedwith intensive care unit mortality" 38 : 838-842, 2010

      18 Ali NA, "Glucose variability and mortality inpatients with sepsis" 36 : 2316-2321, 2008

      19 Watada H, "Glucose fluctuationon the progression of diabetic macroangiopathy: Newfindings from monocyte adhesion to endothelial cells" 77 (77): 58-61, 2007

      20 Nadkarni VM, "First documented rhythm and clinicaloutcome from in-hospital cardiac arrest among childrenand adults" 295 : 50-57, 2006

      21 Beiser DG, "Derangements in blood glucose following initial resuscitationfrom in-hospital cardiac arrest: a report from thenational registry of cardiopulmonary resuscitation" 80 : 624-630, 2009

      22 Heyland DK, "Canadian clinical practice guidelines for nutrition supportin mechanically ventilated, critical ill adult patients" 27 : 355-373, 2003

      23 Mullner M, "Blood glucose concentration after cardiopulmonaryresuscitation influences funtional neurologicalrecovery in human cardiac arrest survivors" 17 : 430-436, 1997

      24 Steingrub JS, "Blood glucose and neurologicoutcome with global brain ischemia" 24 : 802-806, 1996

      25 Wiener RS, "Benefits and risks oftight glucose control in critically ill adults: A meta-analysis" 300 : 933-944, 2008

      26 Skrifvars MB, "Amultiple logistic regression analysis of in-hospital factorsrelated to survival at six months in patients resuscitatedfrom out-of-hospital ventricular fibrillation" 59 : 319-328, 2003

      27 Hirshberg E, "Alterations in glucosehomeostasis in the pediatric intensive care unit:hyperglycemia and glucose variability are associated withincreased mortality and morbidity" 9 : 361-366, 2008

      28 Monnier L, "Activation of oxidative stress by acute glucosefluctuations compared with sustained chronic hyperglycemiain patients with type 2 diabetes" 295 : 1681-1687, 2006

      29 Preiser JC, "A prospective randomised multi-centrecontrolled trial on tight glucose control by intensivetherapy in adult intensive care units: the Glucontrol study" 35 : 1738-1748, 2009

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      2015-01-01 평가 등재학술지 유지 (등재유지) KCI등재
      2011-01-01 평가 등재학술지 유지 (등재유지) KCI등재
      2009-01-01 평가 등재학술지 유지 (등재유지) KCI등재
      2006-01-01 평가 등재학술지 선정 (등재후보2차) KCI등재
      2005-01-01 평가 등재후보 1차 PASS (등재후보1차) KCI등재후보
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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0.23 0.23 0.22
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0.22 0.22 0.339 0.06
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