What is the recommended glucose management strategy after pediatric cardiac arrest?

• A. Ignore glucose levels
• B. Target hyperglycemia to ensure energy supply
• C. Monitor glucose and maintain normoglycemia; treat hypo- and hyperglycemia as needed
• D. Maintain strictly hypoglycemia to reduce brain glucose

Answer: (C)

After pediatric cardiac arrest, the brain is highly vulnerable to further injury, and glucose levels can influence that recovery. The best approach is to monitor glucose closely and keep it in the normal range, correcting lows and highs as they occur. This normoglycemic strategy helps ensure the brain has a steady energy supply without the harm that comes from too little glucose or too much.

Hyperglycemia and hypoglycemia both worsen neurologic outcomes after arrest, so aiming for normal glucose values is preferred over trying to force high glucose for energy or keeping glucose low to “protect” the brain. In practice, this means frequent glucose checks, treating hypoglycemia promptly (for example, with dextrose), and using protocols to reduce hyperglycemia (often with insulin) as needed, all within a safe pediatric range (roughly around 80–180 mg/dL, adjusting per institutional guidelines).