Transient extreme insulin resistance in a patient requiring extracorporeal membrane oxygenation for cardiogenic shock: A case report

Table 1 Case reports of transient extreme insulin resistance in patients with adverse cardiac events

Ref.	Myocardial infarction	Concurrent conditions	Therapeutic hypothermia	Peak insulin infusion rate	Peak insulin daily dose	Peak to resolution time	Duration of insulin infusion	Rebound hypoglycemia	Vasopressors	Peak lactate	Mechanical circulatory support	Outcome
Current paper	STEMI	Cardiac arrest (20 minutes), metabolic acidosis, acute kidney injury (dialysis)	Yes (34 ℃)	450 units/hour	4300 units	13 hours	38 hours	No	Epinephrine Norepinephrine dopamine	10.8 mmol/L	Veno-arterial extracorporeal membrane oxygenation	Survived
Wei et al[5]	NSTEMI	Cardiac arrest (6 minutes), sepsis, mixed acidosis, pneumonia, acute respiratory failure, AKI (dialysis)	Yes (no temperature reported)	960 units/hour	18 224 units	8 hours	11 days	Yes	Norepinephrine	19 mmol/L	No	Deceased (recurrent sepsis)
July et al[14]	STEMI	Cardiac arrest (unknown duration). acute kidney injury (renal replacement therapy), metabolic acidosis	Yes (32 ℃)	280 units/hour	Not reported	24 hours	5 days	No	No	1.9 mmol/L	No	Deceased (anoxic brain damage)
Oo et al[6]	NSTEMI	Diabetic ketoacidosis, acute on chronic kidney injury	No	120 units/hour	2400 units	> 5 days	26 days	No	No	Not reported	No	Survived
Surani et al[16]	None	Cardiac arrest (unknown duration)	No	832 units/hour	> 15 000 units	6 hours	25 hours	No	Norepinephrine	Not reported	No	Not reported
Yokoyama et al[9]	NSTEMI	Diabetic ketoacidosis, rhabdomyolysis, acute kidney injury, pneumonia, disseminated intravascular coagulation.	No (however, body temperature was 35 ℃ on arrival)	10 000 units/hour	91 580 units (over 25 hours)	6 hours	25 hours	Yes	Dopamine	Not reported	No	Survived

AKI: Acute kidney injury.