After pediatric ROSC, how should blood glucose be managed?

• A. Monitor and maintain normoglycemia; treat hypo- or hyperglycemia as indicated.
• B. Maintain hyperglycemia.
• C. Ignore glucose management after ROSC.
• D. Administer insulin immediately.

Answer: (A)

After ROSC in a child, keeping blood glucose in the normal range is crucial for the brain and overall recovery. Both low and high glucose levels can worsen neurological outcomes, so the goal is to continuously monitor and maintain normoglycemia, treating hypo- or hyperglycemia as they arise. This approach supports brain protection after a cardiac arrest and avoids the risks of leaving glucose imbalanced.

That’s why the best choice is to monitor and maintain normoglycemia and treat deviations as indicated. It’s not appropriate to aim for hyperglycemia, ignore glucose management, or jump to insulin therapy without clear evidence of hyperglycemia and careful monitoring, as that could cause dangerous hypoglycemia or other complications.