GLUCOSE GIVEN AFTER HYPOXIC ISCHEMIA DOES NOT AFFECT BRAIN INJURY IN PIGLETS

Background and Purpose Giving glucose before hypoxic ischemia worsens brain injury in piglets. Does giving glucose after hypoxic ischemia af fect 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 st ress-induced 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 fr action of inspired oxygen (FIO2) was reduced to 6%. At 30 minutes FIOZ was increased to 100%, the carotids were released, and the withdrawn blood was reinfused. The piglets were then randomized to receive eithe r 2 mL/kg of 50% dextrose followed by 2 mL/kg per hour for 2 hours or an equal volume of saline. Results Neurological examination scores (20 is normal, 5 is brain dead, by blinded observer) at 1 day postinjury were similar in the two groups: glucose, median 15.5 (25th percentile, 12.2; 75th percentile, 18); controls, 15.6 (9.3, 18). Piglets were ki lled at 3 days with brain preservation at death. Pathological examinat ion scores (sum of scores from cortex, hippocampus, and basal ganglia: 30 is normal, 3 is total necrosis) by blinded observer were similar i n the two groups: glucose, 26 (18, 28); controls, 25 (16.5, 28); NS. C onclusions Although elevated glucose levels during hypoxic ischemic in jury worsen brain injury in the piglet, elevated glucose levels after injury do not affect the severity of the injury.