Clinical, biochemical and histochemical assessment of pretreatment with glucose–insulin–potassium for patients undergoing mitral valve replacement in the third and fourth functional groups of the New York Heart Association

Beşoğul, Yavuz; Tünerir, Bülent; Aslan, Recep; Işıksoy, Serap; Çolak, Ömer; Kural, Tuğrul

doi:10.1016/s0967-2109(99)00047-2

Cited by 13 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Twenty-five of the 38 studies report positive results with regard to GIK infusions [12,[16][17][18]21,26,[32][33][34][37][38][39]46,49,51,[53][54][55][56][57]59,[63][64][65][66][67], 11 studies report neutral or negative results [13,22,27,35,52,58,60,61,[68][69][70], and two studies [50,62] argue neither for nor against GIK infusions, as both studies were primarily not aimed at GIK effects but on other endpoints.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, details on the age were missing, and the medical history, such as prior chest pain and infarctions, was only poorly presented [54]. Another study reports on surprisingly young patients (mean age: 38 years) who were mostly females (mean age: 35 years) [59]. Thus, this study includes patients who are not representative for open heart surgery.…”

Section: Recruitment Of Groups and Randomizationmentioning

confidence: 99%

See 1 more Smart Citation

Forty years of glucose–insulin–potassium (GIK) in cardiac surgery: a review of randomized, controlled trials

Schipke

Friebe

Gams

2006

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

Glucose-insulin-potassium (GIK) solutions have been used in cardiac surgery for more than 40 years. At that time, membrane-polarizing and stabilizing effects on cardiomyocyte's action potential were regarded the main benefit. Two meta-analyses described methodological flaws in the early studies (e.g., case numbers, randomization principles, and levels of significance), and came to clearly different recommendations with regard to the usage of GIK in the therapy of acute myocardial function. During the 70s, as promising therapies for the treatment of AMI had become available (e.g., beta-blockers and thrombolytic agents), the GIK technique was more widely introduced in cardiac surgery, e.g., during valve replacement. At present, 74 of 91 studies provide convincing evidence for the beneficial effects of insulin and/or GIK in cardiac surgery that go far beyond simple metabolic benefits and also include better recovery of myocardial tissue after ischemia. Yet, the exact underlying mechanisms remain still unknown. In this review article, two questions will be answered: why did GIK not become daily routine in cardiac surgery in spite of positive results from clinical studies, and does this technique merit more acceptance among the potential users? In view of the increasing number of older patients at higher risk, the demand for improving surgical procedures has renewed the interest in the GIK concept. The more recent literature suggests that the entire potential of GIK solutions has not been fully disclosed. A large single or multicenter trial with sound endpoints is mandatory.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Recruitment Of Groups and Randomizationmentioning

confidence: 99%

Forty years of glucose–insulin–potassium (GIK) in cardiac surgery: a review of randomized, controlled trials

Schipke

Friebe

Gams

2006

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…15,17,19,45,46,50 Therefore, it appears that the potential benefit of GIK infusion for myocardial infarction is attenuated with concomitant use of reperfusion therapy. However, GIK infusion may still have in important role in the period before reper- 15,17,19,20,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]42,[44][45][46][47][49][50][51]53 32 26234 9.98 0.96 (0.89-1.03) GIK in AMI 15,17,19,[22][23][24][25][26][27][28][29][30]…”

Section: Methods Of Insulin Administration Gik Vs Non-gikmentioning

confidence: 99%

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

Pittas

Siegel

Lau

2006

J Parenter Enteral Nutr

151

111

View full text Add to dashboard Cite

show abstract

“…The administration of glucose prior to anoxia has been shown to increase the glycogen concentration and consequently the energy available [25]. The relationship between the beneficial effects of an IGK pretreatment and the glycogen content can be found in patients undergoing mitral valve replacement [26]. …”

Section: Discussionmentioning

confidence: 99%

The effects of an insulin-glucose-potassium (IGK) pretreatment on the bupivacaine cardiotoxicity

Kim

Yang²,

Lee

2013

Korean J Anesthesiol

View full text Add to dashboard Cite

BackgroundThe purpose of this study is to evaluate the effect of an IGK pretreatment on the cardiotoxicity of bupivacaine.MethodsTwenty-one anesthetized mongrel dogs were randomly divided into the following three groups: the control group (CG, n = 7), the treatment group (TG, n = 7) and the pretreatment group (PTG, n = 7). For the 30 min of pretreatment period, CG and TG received normal saline, while PTG received an IV bolus of insulin 2 U/kg, followed by an IGK infusion (2 U/kg/hr of insulin, 0.5-1.5 g/kg/hr of glucose, 1-2 mEq/kg/hr of KCl). The bupivacaine infusion was started at the rate of 0.5 mg/kg/min in all groups after the pretreatment period. CG received normal saline only. In TG, insulin (2 U/kg) was injected simultaneously with bupivacaine infusion, followed by the IGK infusion as with PTG. The hemodynamic variables and the time duration to reach the mean arterial pressure (MAP) of 60 mmHg were compared.ResultsThe bupivacaine infusion decreased the cardiac index, MAP, and heart rate in all three groups. Although insulin concentration was higher in TG than in PTG during bupivacaine infusion, the hemodynamic variables in PTG decreased at the slowest rate. The time taken to reach MAP of 60 mmHg in PTG, TG, and CG was 51.4 ± 8.5, 36.4 ± 9.6, and 27.1 ± 8.7 min, respectively (P < 0.05).ConclusionsIGK delays the bupivacaine-induced cardiac depression. However, a pretreatment with IGK is more effective in delaying the bupivacaine-induced hypotension than simultaneous administration, regardless of insulin concentration.

show abstract

Clinical, biochemical and histochemical assessment of pretreatment with glucose–insulin–potassium for patients undergoing mitral valve replacement in the third and fourth functional groups of the New York Heart Association

Cited by 13 publications

References 23 publications

Forty years of glucose–insulin–potassium (GIK) in cardiac surgery: a review of randomized, controlled trials

Forty years of glucose–insulin–potassium (GIK) in cardiac surgery: a review of randomized, controlled trials

Insulin Therapy and In‐Hospital Mortality in Critically Ill Patients: Systematic Review and Meta‐analysis of Randomized Controlled Trials

The effects of an insulin-glucose-potassium (IGK) pretreatment on the bupivacaine cardiotoxicity

Contact Info

Product

Resources

About