The Effect of Glucose-Insulin-Potassium Infusion in Patients Undergoing Cardiac Surgery

The Effect of Glucose-Insulin-Potassium Infusion on Myocardial Injuries and Cardiac Function in Patients Undergoing Cardiac Surgery

The purpose of this study is to evaluate the cardioprotective effects of a short term infusion of glucose-insulin-potassium (GIK) during heart surgery.

Cardiac surgery with cardiopulmonary bypass and ischemic cardiac arrest is associated with a wide spectrum of perioperative myocardial ischemic-reperfusion injuries resulting in significant cardiac morbidity, namely contractile dysfunction, myocardial infarction, and low cardiac output syndrome requiring prolonged intensive care and hospital stay. The infusion of glucose-insulin-potassium (GIK) is one of the oldest cardioprotective interventions during cardiac surgery. Although experimental evidence is strong, clinical data remain conflicting. We will investigate the impact of short term GIK on the extent of myocardial injuries as well as on the left-ventricular systolic and diastolic function in 2 high-risk groups of cardiac surgical patients: Patients with cardiac dysfunction undergoing aortocoronary bypass surgery and patients with severe aortic stenosis.

Inclusion Criteria:

• Severe aortic stenosis
• Coronary artery disease associated with poor left ventricular function
• Parsonnet score >7

Exclusion Criteria:

• Dementia or inability to understand the study protocol
• Off-pump and emergent cardiac surgery
• Poorly controlled diabetes mellitus
• Severe renal insufficiency
• Abnormal liver function Child-Plugh - C
• Body Mass Index < 18 and > 35