Table 1 Inclusion and exclusion criteria

Inclusion criteria

 1. Age ≥ 18 years

 2. OHCA of presumed cardiac cause

 3. Sustained ROSC, defined as ROSC when chest compressions have not been required for 20 consecutive minutes and signs of circulation persist

 4. Unconsciousness (Glasgow coma scale (GCS) < 8) after sustained ROSC

Exclusion criteria

 1. Conscious patient (GCS ≥ 8)

 2. Female of childbearing potential, unless a negative human chorionic gonadotropin (HCG) test can rule out pregnancy within the inclusion window

 3. In-hospital cardiac arrest (IHCA)

 4. OHCA of presumed non-cardiac cause, e.g. after trauma, dissection/rupture of major artery or arrest caused by hypoxia (i.e. drowning or hanging)

 5. Known bleeding diathesis (medically induced coagulopathy does not exclude patient)

 6. Suspected or confirmed acute intracranial bleeding

 7. Suspected or confirmed acute ischemic stroke

 8. Unwitnessed asystole

 9. Known limitations in therapy and do-not-resuscitate order

 10. Known disease making 180-day survival unlikely

 11. Known pre-arrest cerebral performance category score (CPC) of 3 or 4

 12. > 4 hours (240 minutes) from ROSC to randomization

 13. Systolic blood pressure < 80 mmHg in spite of fluid loading/vasopressor and/or inotropic medication and/or mechanical circulatory support^a

 14. Temperature on admission < 30 °C

 15. Known allergy to GLP-1 analogues, including Exenatide

 16. Known pancreatitis

 17. Known ketoacidosis

 18. Uncorrected blood glucose at admission < 2.5 mmol/l