The following is a summary of “Association between metformin and survival outcomes in in-hospital cardiac arrest patients with diabetes” published in the October 2022 issue of Critical Care by Jin, et al.

Metformin’s neuroprotective and cardioprotective properties have been demonstrated in animal models of cardiac arrest and ischemia-reperfusion injury. Therefore, the purpose of this study was to assess whether or not type 2 DM (T2DM) patients who experienced in-hospital cardiac arrest (IHCA) benefited from taking their diabetes medication before and throughout their hospital stay.

Between April 2017 and March 2022, adult IHCA patients with T2DM were included in retrospective observational research. The timing of diabetes medication use within the last 24 hours preceding cardiac arrest was a key variable. To examine the correlation between these factors, a multivariate logistic regression was conducted.

Metformin given within 24 hours before IHCA improved survival to discharge and neurologic prognosis in 377 patients (41.5% vs 11.7%, P<0.001 and 18.9% vs 6.2%, P=0.004, respectively). Survival to discharge and favorable neurologic outcome were independently linked with metformin administration within 24 hours before IHCA (adjusted odds ratio [aOR]: 5.37, 95% CI: 2.13-13.53, P<0.001 and aOR: 3.57, 95% CI: 1.14-11.17, P=0.029). Patients who were given 500-1000 mg of metformin daily had the highest rate of survival to discharge (P<0.001). Patients with type 2 diabetes who experienced IHCA had a higher chance of surviving to discharge if they had been given metformin within the preceding 24 hours.