Glucose given after hypoxic ischemia does not affect brain injury in piglets.

Abstract

Background and Purpose Giving glucose before hypoxic ischemia worsens brain injury in piglets. Does giving glucose after hypoxic ischemia affect severity of injury?Methods Forty-three 0-to 3-day-old pigs were used. All piglets received 2 U/kg insulin before injury to prevent stressinduced hyperglycemia. Hypoxic ischemic brain damage was induced by clamping both carotid arteries and reducing arterial blood pressure to two thirds of normal by hemorrhage at time 0. At 15 minutes the fraction of inspired oxygen (Fio?) was reduced to 6%. At 30 minutes FiOj was increased to 100%, the carotids were released, and the withdrawn blood was reinfused. The piglets were then randomized to receive either 2 mL/kg of 50% dextrose followed by 2 mL/kg per hour for 2 hours or an equal volume of saline.

Part 15: Neonatal Resuscitation

“…91,92 Increased glucose levels after hypoxia or ischemia were not associated with adverse effects in a recent pediatric series 93 or in animal studies, 94 and they may be protective. 95 However, there are no randomized controlled trials that examine this question.…”

Electrophysiological changes in isolated spinal cord white matter in response to oxygen deprivation

“…This is consistent with the previous observation that glucose given after hypoxic ischemia does not affect brain injury in piglets. 26 Furthermore, it has been suggested that glucose may worsen the outcome of functional recovery following ischemic injury, 27,28 possibly through the promotion of an intracellular lactic acidosis where associated hydrogen ions are injurious to neurons and glia. 29 Membrane potential depolarization is likely due to ionic imbalances across the axonal membrane as a result of lower energy levels, which stem from oxygen deprivation.…”

Effects of Exogenous Glucose on Brain Ischemia in Ovine Fetuses

“…Whether or not increases in glucose concentrations before and during perinatal hypoxic-ischemic episodes are detrimental or beneficial to the immature CNS remains uncertain. Increases in glucose have been reported to promote survival (21), not to affect (22,23) and to exacerbate CNS damage (24,25).…”