Glucose plus insulin infusion improves cerebral outcome after asphyxial cardiac arrest

HYPERGLYCEMIA before ischemia worsens cerebral outcome. The aim of this study was to determine the cerebral effects of giving glucose with or without insulin after asphyxial cardiac arrest. Rats underwent 8 min of asphyxial cardiac arrest. After arrest, Group 1 received NaCl; Group 2, insulin; Group 3, glucose; and Group 4, glucose plus insulin, all intravenously. Neurological deficit (ND) scores were 14 ± 10%, 22 ± 12%, 12 ± 10% and 2 ± 2% in Groups 1–4, respectively, 72 h after reperfusion. Overall histological damage (HD) scores were 4, 2, 3 and 1, respectively. Group 4 fared significantly better than group 1 on both scores. Glucose after asphyxial cardiac arrest in rats produces no increased brain damage while glucose plus insulin improves cerebral outcome.

[1]  C. Z. Zhu,et al.  Intraventricular Administration of Insulin and IGF-1 in Transient Forebrain Ischemia , 1994, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[2]  R. Busto,et al.  Moderate Hyperglycemia Worsens Acute Blood‐Brain Barrier Injury After Forebrain Ischemia in Rats , 1993, Stroke.

[3]  M. Zemel,et al.  Insulin-stimulated vascular relaxation. Role of Ca(2+)-ATPase. , 1992, American journal of hypertension.

[4]  R. Traystman,et al.  Special issues: Glucose and the brain , 1992, Critical care medicine.

[5]  R. Auer,et al.  Insulin Attenuates Ischemic Brain Damage Independent of its Hypoglycemic Effect , 1991, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[6]  R. Auer,et al.  The effect of postischemic blood glucose levels on ischemic brain damage in the rat , 1988, Annals of neurology.

[7]  Y. Olsson,et al.  Hypoglycemic Brain Injury in the Rat: Correlation of Density of Brain Damage with the EEG Isoelectric Time: A Quantitative Study , 1984, Diabetes.

[8]  L. Swanson.  The Rat Brain in Stereotaxic Coordinates, George Paxinos, Charles Watson (Eds.). Academic Press, San Diego, CA (1982), vii + 153, $35.00, ISBN: 0 125 47620 5 , 1984 .

[9]  S. Rehncrona,et al.  Brain Lactic Acidosis and Ischemic Cell Damage: 1. Biochemistry and Neurophysiology , 1981, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[10]  R. Myers,et al.  Nervous system effects of cardiac arrest in monkeys. Preservation of vision. , 1977, Archives of neurology.

[11]  G. Paxinos,et al.  The Rat Brain in Stereotaxic Coordinates , 1983 .