Evidence map›Paper›PMID 39407074›Full record

Observational studyNeurocritical care2025

Liberalization of the Systemic Glucose Management is Associated with a Reduced Frequency of Neuroglucopenia in Subarachnoid Hemorrhage Patients: An Observational Cohort Study.

Mario Kofler, Anna Lindner, Verena Rass, Bogdan A Ianosi, Lauma Putnina, Philipp Kindl, Alois J Schiefecker, Maxime Gaasch, Ronny Beer, Paul Rhomberg and 4 more

Abstract readObservational Study
In one paragraph

Observational study in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Mario KoflerDepartment of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Anna LindnerDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Verena RassDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Bogdan A IanosiDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Lauma PutninaDepartment of Anaesthesiology and Critical Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.
Philipp KindlDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Alois J SchiefeckerDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Maxime GaaschDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Ronny BeerDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Paul RhombergDepartment of Neuroradiology, Medical University of Innsbruck, Innsbruck, Austria.
Claudius ThoméDepartment of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria.
Erich SchmutzhardDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Bettina PfauslerDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Raimund HelbokDepartment of Neurology, Medical University of Innsbruck, Innsbruck, Austria. Raimund.Helbok@kepleruniklinikum.at.ORCID 0000-0001-5682-0145

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPathologically low brain glucose levels, referred to as neuroglucopenia, are associated with unfavorable outcomes in neurocritical care patients. We sought to investigate whether an increase in serum glucose levels would be associated with a reduction of neuroglucopenia.

methodsIn this retrospective analysis of prospectively collected data, we included 55 consecutive patients with spontaneous subarachnoid hemorrhage who underwent cerebral microdialysis (CMD) monitoring. Neuroglucopenia was defined as CMD-glucose levels < 0.7 mmol/l. We identified systemic glucose liberalization events, defined as a day with median serum glucose levels < 150 mg/dl, followed by a day with median serum glucose levels > 150 mg/dl, and compared concentrations of cerebral metabolites between these days. Unfavorable outcome was defined as modified Rankin Scale score ≥ 3 at 3 months after the bleeding.

resultsEpisodes of neuroglucopenia were more frequent in patients with unfavorable outcome (19.8% [19.3-20.3%] vs. 10.9% [10.4-11.5%], p = 0.007). Sixty-nine systemic glucose liberalization events were identified in 40 patients. Blood glucose levels increased from 141.2 (138.7-143.6) mg/dl to 159.5 (157.0-162.2) mg/dl (p < 0.001), CMD-glucose levels increased from 1.44 (1.39-1.50) mmol/l to 1.68 (1.62-1.75) mmol/l (p = 0.001), and the frequency of neuroglucopenia decreased from 24.7% (22.9-26.5%) to 20.2% (18.7-21.8%) (p = 0.002) during these events. Liberalization was not associated with changes in CMD-lactate, CMD-pyruvate, CMD-lactate-to-pyruvate ratio, CMD-glutamate, or CMD-glycerol.

conclusionsIn conclusion, the liberalization of serum glucose concentrations to levels between 150 and 180 mg/dl was associated with a significant reduction of neuroglucopenia.

Indexed as

Blood GlucoseBrain Diseases, MetabolicGlucoseHypoglycemiaSubarachnoid HemorrhageAdultAgedFemaleHumansMaleMicrodialysisMiddle AgedRetrospective StudiesBlood GlucoseGlucoseCerebral metabolismCerebral microdialysisGlucoseNeurocritical careSubarachnoid hemorrhage

Identifiers

PMID39407074
PMCPMC11950053

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.