491 - Blood sugar levels and its association with neonatal resuscitation using an ovine cardiac arrest model

Poster Number: 491

Arun Prasath, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Williamsville, NY, United States; Sylvia Gugino, SUNY at Buffalo, Buffalo, NY, United States; Justin Helman, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Bufalo, NY, United States; Nicole Bradley, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Lori Nielsen, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, buffalo, NY, United States; Aditya Gupta, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Clariss Blanco, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Mausma Bawa, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Andreina Mari, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Depew, NY, United States; Jayasree Nair, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Vasantha H. Kumar, University at Buffalo, Buffalo, NY, United States; Munmun Rawat, University at Buffalo, Buffalo, NY, United States; Praveen Chandrasekharan, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States

Background: In neonates, glucose consumption increases during anaerobic metabolism. Hypoglycemia could occur because of the rapid depletion of glucose stores during perinatal stress. Glucose is an essential fuel for brain function in newborns and prolonged hypoglycemia could contribute to brain injury after resuscitation. It remains unknown if neonates who are subjected to extensive resuscitation with low blood sugars have similar rates and time to establish return of spontaneous circulation (ROSC) compared to those who have higher blood sugar levels.

Objective: We seek to understand the association between the effect of blood sugar levels on extensive neonatal resuscitation using a near-term ovine model on, a) times and rates of ROSC, b) blood sugars during resuscitation and at ROSC and, c) the difference between the blood sugar levels between lambs that did and did not achieve ROSC.

Design/Methods: Near-term lambs 139 - 141 days were instrumented and cardiac arrest was induced by umbilical cord occlusion. These ovine models required extensive resuscitation and blood sugars were collected as part of blood gas analysis before, at cardiac arrest, and every minute during resuscitation until ROSC or 20 min of resuscitation. The baseline blood sugars were consistently 20±5mg/dl. For this study, we defined hypoglycemia as ≤ 20 mg/dl and normoglycemia as >20 mg/dl at the start of the resuscitation.

Results: We included historical data from a total of 85 lambs with 47 having hypoglycemia and 38 having normoglycemia (Fig 1). The blood sugars were significantly lower in the hypoglycemia group at the start of resuscitation (fig 1). The time to ROSC was faster in the normoglycemia group, however, this was not significant (fig 1). The comparison of blood sugar during arrest, resuscitation, and at ROSC or at 20 min if the lambs did not achieve ROSC is shown in figure 2 (a & b). Interestingly we observed significantly higher blood sugar levels during resuscitation in lambs that did not achieve ROSC compared to those that achieved ROSC (Fig 2C).Conclusion(s): Lambs that achieved ROSC had lower blood sugars during resuscitation. We speculate that this could be secondary to the increased energy need during resuscitation. Future studies comparing the effect of a dextrose bolus when extensive neonatal resuscitation is needed may help us further understand the role of blood sugar levels.
Arun Prasath MD, Neonatal-Perinatal Medicine Fellow.CV.AP.pdf
Figure 2