What happens to the brain in a hypoglycemic patient?

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Page 2

  All
(n = 49)
Good outcome (mRS ≤ 3)

(n = 18)

Poor outcome (mRS > 3)
(n = 31)
P value
Male 27 (55) 9 (50) 18 (58) 0.28
Age (years) 55 [44–70] 52 [39–64] 56 [45–71] 0.11
Chronic alcohol abuse 17 (35) 5 (28) 12 (39) 0.23
Diabetes 29 (59) 8 (44) 21 (68) 0.01
SAPS II 55 [49–60] 54 [44–61] 55 [50–60] 0.75
mRS prior to ICU admission 1 [0–2] 0 [0–1] 1 [0–2] 0.03
Etiology
 Insulin and/or oral antidiabetics 32 (65) 12 (67) 20 (65) 0.89
 Neuroendocrine carcinoma 8 (16) 2 (11) 6 (19)  
 Alcohol abuse 2 (4) 1 (6) 1 (3)  
 Adrenal insufficiency 1(2) 1 (6) 0 (0)  
 Unknown 6 (12) 2 (11) 4 (13)  
Duration of hypoglycemia, min (n = 27) 480 [35–720] 45 [30–120] 660 [187–1283] 0.006
Initial glycemia (g/L) 0.21 ± 0.02 0.22 ± 0.03 0.20 ± 0.02 0.51
Glycemia on ICU admission (g/L) 1.01 ± 0.58 1.05 ± 0.16 1.50 ± 0.44 0.45
GCS
 Initial 4 ± 1 4 ± 1 4 ± 1 0.45
 After glycemia normalization 5 ± 1 5 ± 2 5 ± 1 0.89
Seizures 8 (16) 6 (33) 2 (6) <0.001
Temperature (°C)
 Initial 36.6 ± 0.2 36.7 ± 1.2 36.7 ± 0.5 0.91
 Highest during first 24 h 37.9 ± 0.8 37.7 ± 0.8 38.0 ± 1.2 0.36
Initial arterial pH 7.38 ± 0.08 7.36 ± 0.12 7.40 ± 0.06 0.23
Initial lactate level (mmol/L) 2.54 ± 0.67 3.23 ± 1.36 2.10 ± 1.75 0.17
Time to final glycemia normalization (min) 180 [60–705] 480 [120–720] 180 [67–630] 0.78
Mechanical ventilation 46 (94) 16 (89) 30 (97) 0.55
Length of mechanical ventilation (days) 7 [3–12] 4.5 [2–8] 8 [6–13] 0.08
Normal EEG (n = 34) 1(3) 1 (10) 0 (0) 0.37
Normal brain imaging (n = 45) 25 (55) 11 (73) 14 (46) 0.009
Acquired ICU complications
 Pneumonia 25 (51) 8 (44) 17 (55) 0.28
 Septic shock 8 (16) 3 (17) 5 (16) 0.78
ICU length of stay (days) 11 [5.5–17] 8 [4–14] 11 [7–17] 0.57
At least 1-year follow-up, days (n = 27) 840 [394–1768] 826 [407–1906] 1373 [388–1997] 0.93

  1. Values are n(%), mean ± SD or median [IQR]
  2. GCS Glasgow Coma Score, SAPS II Simplified Acute Physiological Score (version II)