Glucose-insulin-potassium solutions enhance recovery after urgent coronary artery bypass grafting.

Abstract

OBJECTIVE:

This prospective, randomized, clinical study was undertaken to determine whether glucose-insulin-potassium solutions would benefit patients undergoing coronary artery bypass grafting because of unstable angina.

METHODS:

The study group consisted of 30 patients with unstable angina who required coronary artery bypass grafting. In 15 patients, glucose-insulin-potassium solution (30% dextrose in water; K+, 80 mEq/L: regular insulin, 50 units) was given intravenously at 1 ml/kg per hour after induction of anesthesia and administration continued for 12 hours after aortic unclamping. Fifteen patients in a separate group received 5% dextrose in water intravenously at 50 ml/hr.

RESULTS:

Patients treated with glucose-insulin-potassium solution had higher cardiac indices (2.8 +/- 0.1 vs 2.0 +/- 1 L/min per square meter; p < 0.001), lower inotrope scores (0.06 +/- 0.01 vs 0.46 +/- 0.19; p = 0.041), and less weight gain (6.4 +/- 9 vs 11.6 +/- 1.1 pounds; p < 0.001) and had shorter times of ventilator support (8.3 +/- 0.6 vs 14.2 +/- 0.2 hours; p = 0.003). They had a significantly lower incidence of atrial fibrillation (13.3% vs 53.3%; p = 0.020) and had shorter stays in the intensive care unit (14.8 +/- 1.3 vs 31.6 +/- 5.2 hours; p = 0.002) and in the hospital (6.0 +/- 0.4 vs 8.0 +/- 0.7 days; p = 0.010).

CONCLUSIONS:

We conclude that glucose insulin-potassium therapy enhances myocardial performance and results in faster recovery from urgent coronary artery bypass grafting.

• Authors: H L Lazar, G Philippides, C Fitzgerald, D Lancaster, R J Shemin, C Apstein
• Journal: The Journal of thoracic and cardiovascular surgery (J Thorac Cardiovasc Surg) Vol. 113 Issue 2 Pg. 354-60; discussion 360-2 (Feb 1997) ISSN: 0022-5223 [Print] United States
• PMID: 9040630 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Cardioplegic Solutions
• Insulin
• glucose-insulin-potassium cardioplegic solution
• Glucose
• Potassium

Topics

• Adult
• Aged
• Aged, 80 and over
• Angina, Unstable (drug therapy)
• Atrial Fibrillation (etiology)
• Cardioplegic Solutions (therapeutic use)
• Coronary Artery Bypass
• Emergencies
• Female
• Glucose (therapeutic use)
• Humans
• Insulin (therapeutic use)
• Male
• Middle Aged
• Postoperative Complications
• Potassium (therapeutic use)
• Prospective Studies
• Treatment Outcome