Myocardial Protection with Glucose-Insulin-Potassium Infusion during Cardiopulmonary Bypass for Coronary Revascularization

Abd El-Hakeem, Essam Ezzat; Aly, Ahmed Elsaied Abd Elrahman; Mahmoud, Osama Salah El Din; Hassan, Ahmad Hamody

doi:10.21608/ejhm.2021.140446

Myocardial Protection with Glucose-Insulin-Potassium Infusion during Cardiopulmonary Bypass for Coronary Revascularization

Document Type : Original Article

Authors

¹ Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Assiut University

² Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Sohag University, Egypt

10.21608/ejhm.2021.140446

Abstract

Background: Sodi-Pallares and colleagues first time introduced use of glucose-insulin and potassium (GIK) solution for myocardial protection. They used this solution in patients with acute myocardial infarction and concluded that GIK solution limited electrocardiographic changes in these patients.
Objective: To investigate the effectiveness of the GIK solution regarding myocardial protection evaluated by postoperative creatine kinase MB (CKMB) and cardiac troponin I levels.
Method: In this prospective, randomized clinical trial, sixty-four patients were assigned into two groups: GIK group, in which glucose-insulin and potassium infusion were given during surgery, and non-GIK group in which only saline infusion was given during the procedure.
Results: All CK-MB values were lower in the GIK group than the Non-GIK group in the postoperative period (6, 12 and 24 hours’ samples) with statistically significant results. Troponin values were lower in the GIK group versus the Non-GIK group after 6 and 12 hours with statistical significance (P < 0.001 and 0.022 respectively). Conclusion: The addition of GIK infusion throughout the operation to standard myocardial protective techniques in patients undergoing on-pump coronary artery bypass graft (CABG) surgery attenuates myocardial ischemic injury.

Keywords