Hypoglycemia and Cardiac Arrest in a Critically Ill Patient on Strict Glycemic Control

Abstract
Glycemic control in critically ill patients has become a subject of considerable interest since the publication of studies showing reduced morbidity and mortality in patients when blood glucose was maintained within a relatively low and narrow range (4.4 to 6.1 mM/L). We describe a patient who developed cardiac asystole while being given a concentrated glucose solution to treat severe hypoglycemia after administration of insulin. The mechanism in this patient appears to be hyperkalemia from the rapid administration of a concentrated glucose solution.

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