Cardiac Subspecialty Certification Practice Test

During rewarming, blood glucose levels are anticipated to decrease, primarily leading to hypoglycemia. This phenomenon is mainly due to metabolic changes that occur as the body transitions from a hypothermic state to normal temperature. In hypothermia, insulin secretion is reduced, and glucose metabolism is altered because of the low metabolic rate.

As rewarming proceeds, normal metabolic processes resume, and insulin sensitivity may increase, facilitating more profound glucose uptake by tissues. This process can be exacerbated if the patient has an underlying condition such as diabetes, where there might be a mismatch between the actions of exogenous insulin and the body’s metabolic demands during the rewarming process. Therefore, monitoring blood glucose levels is crucial, as they can drop significantly during this phase, leading to hypoglycemia.

The concern for stable glycemic levels and severe glucose fluctuations comes from disruption in metabolic stabilization. However, during rewarming, the expectation leans more toward a decrease in blood glucose due to heightened insulin responsiveness and resumption of cellular glucose uptake.