Glucose-insulin-potassium correlates with hemodynamic improvement in patients with septic myocardial dysfunction

Kim, Youn-Jung; Baek, Moon Seong; Kim, Young S.; Seo, Jarim; Huh, Jin Won; Lim, Chae‐Man; Koh, Younsuck; Hong, Sang‐Bum

doi:10.21037/jtd.2016.12.10

Cited by 10 publications

(8 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As regard to length of hospital stay and mortality, we did not find any statistically significant difference between GIK group and control group. These results are supported by Kim et al (2016) who reported that there was no significant benefit in mortality among patients with hypodynamic septic shock who received GIK infusion protocol despite the short-term hemodynamic improvement in that group [20].…”

Section: Discussionmentioning

confidence: 62%

“…There was no statistically significant difference between GIK group and control group regarding development of SCM; however, we found that patients with hypodynamic septic shock showed better improvement in hemodynamic profile, including stroke volume, cardiac output, and cardiac index in the GIK group than in the control group. This finding is supported by Kim et al (2016) as they found that GIK helps to improve cardiac output and other echocardiographic parameters in eight out of 12 patients affected with hypodynamic septic shock, so they suggested that GIK may be effective in septic shock exacerbated by septic myocardial depression [20].…”

Section: Discussionmentioning

confidence: 85%

“…Similarly, Kim et al (2016) in their study conducted on 45 patients with septic shock, found that GIK increased MAP and tended to decrease HR particularly in patients with hypodynamic septic shock [20]. Furthermore, Hamdulay et al (2006) described two cases of septic shock which were resistant to vasopressors and responded to high-dose GIK infusions they found that hemodynamics improved markedly with GIK infusions allowing successful weaning of vasopressors [9].…”

Section: Discussionmentioning

confidence: 94%

“…Similarly, Kim et al (2016) found that the use of GIK solution was well tolerated with minimal adverse drug reactions [20].…”

Section: Discussionmentioning

confidence: 98%

See 3 more Smart Citations

Effect of Glucose-Insulin-Potassium Infusion on Hemodynamics in Patients with Septic Shock

Effat

Khaled

Battah

et al. 2021

Open Access Maced J Med Sci

View full text Add to dashboard Cite

BACKGROUND: Glucose-insulin-potassium (GIK) demonstrates a cardioprotective effect by providing metabolic support and anti-inflammatory action, and may be useful in septic myocardial depression. AIM: The aim of this study was to assess role of GIK infusion in improving hemodynamics in patients with septic shock in addition to its role in myocardial protection and preventing occurrence of sepsis-induced myocardial dysfunction and sepsis-induced arrhythmias. METHODS: This study was conducted on 75 patients admitted to the Critical Care Department in Cairo University Hospital with the diagnosis of septic shock during the period from January 2019 to December 2019. Patients were divided into two groups; first group was managed according to the last guidelines of surviving sepsis campaign and was subjected to the GIK infusion protocol while second group was managed following the last guidelines of surviving sepsis campaign only without adding GIK infusion. RESULTS: Patients in the GIK group showed better lactate clearance (50% vs. 46.7%) and less time needed for successful weaning of vasopressors than the control group (3.57±1.16 vs. 3.6±1.45 days) thought not reaching statistical significance. There was no statistically significant difference between both groups regarding development of septic-induced cardiomyopathy (16.7% in the control group vs. 13.3% in the GIK group); however, patients with hypodynamic septic shock showed better improvement in hemodynamic profile in the GIK group. Sepsis-induced arrhythmias occurred more in patients of the control group than in patients of the GIK group with no statistically significant difference between both groups (33.3% vs. 20%, p = 0.243). Few side effects were developed as a result of using GIK infusion protocol. CONCLUSIONS: GIK may help in improving hemodynamics and weaning of vasopressors in patients with refractory septic shock and those with septic induced cardiomyopathy. The use of GIK was well tolerated with minimal adverse reactions.

show abstract

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 94%

“…Similarly, Kim et al (2016) found that the use of GIK solution was well tolerated with minimal adverse drug reactions [20].…”

Section: Discussionmentioning

confidence: 98%

See 2 more Smart Citations

Effect of Glucose-Insulin-Potassium Infusion on Hemodynamics in Patients with Septic Shock

Effat

Khaled

Battah

et al. 2021

Open Access Maced J Med Sci

View full text Add to dashboard Cite

show abstract

“…12 Patients with hypodynamic septic shock with myocardial depression displayed improved mean arterial pressure and reduced heart rate during the first 72 hours of GIK treatment. Total insulin dose correlated with improvement [45].…”

Section: Glucose Plus Insulinmentioning

confidence: 88%

<strong></strong>Thiamine and High Dose Insulin Treatment for Sepsis<strong> </strong>

Bradley¹

2023

Preprint

View full text Add to dashboard Cite

Sepsis is a major health problem and accounts for 20 per cent of deaths worldwide. It is the most expensive condition treated in United States hospitals at $27 billion per year or about $20,000 per patient. Treatment consisting largely of fluid resuscitation and antibiotics has only marginal impact. Mortality is about 27 per cent for hospitalized patients and about 42 per cent for patients in intensive care.There are two phases of sepsis – a hyper inflammatory phase and a subsequent hypo inflammatory phase.During the hyper inflammatory phase the metabolic rate increases associated with an increase in body temperature and a rapid escalation of immune system functioning including increased numbers of leucocytes and migration of those leucocytes to infected and damaged tissues and an increased supply and consumption of glucose to fuel this immune system.During the subsequent hypo inflammatory phase the metabolic rate declines and this is associated with a decrease in body temperature and a generalized decrease in the physiological activity of many organs including the immune system akin to hibernation. The activated immune system has priority for the available glucose over most other organs and physiological functions during such potentially life threatening circumstances. Thus adenosine triphosphate (ATP) production by mitochondria (the source of energy at the cellular level for the organism as a whole) also has a lower priority for the available glucose relative to the activated immune system. If glucose availability is threatened then mitochondrial production of ATP is partially or substantially suppressed in favor of glycolysis because glycolysis can rapidly produce large quantities of ATP that are necessary for immune cell function in infected, anaerobic, ischemic, or damaged tissues.However, glycolysis is only a temporary fix as it cannot produce the quantities of ATP necessary on an ongoing basis for the normal functioning of the healthy animal. Mitochondrial production of ATP must be recommenced for full recovery.It appears that the partial or substantial suppression of mitochondrial production of ATP by activation of the immune response becomes relatively fixated in some patients leading to a substantial ATP deficit. This is the fundamental issue of sepsis.This paper reviews the metabolism of glucose and insulin during sepsis and concludes that high dose insulin with mild hyper glycaemia in conjunction with the intravenous administration of thiamine, an inhibitor of the pyruvate dehydrogenase kinase enzymes, to re-establish physiological ATP production by mitochondria, administered early in the hypo metabolic (hypo inflammatory) phase of sepsis should significantly improve survival.

show abstract

Therapeutic Strategies Targeting Mitochondrial Dysfunction in Sepsis-induced Cardiomyopathy

Salami

Habimana

Peng

et al. 2022

Cardiovasc Drugs Ther

View full text Add to dashboard Cite

Glucose-insulin-potassium correlates with hemodynamic improvement in patients with septic myocardial dysfunction

Cited by 10 publications

References 40 publications

Effect of Glucose-Insulin-Potassium Infusion on Hemodynamics in Patients with Septic Shock

Effect of Glucose-Insulin-Potassium Infusion on Hemodynamics in Patients with Septic Shock

<strong></strong>Thiamine and High Dose Insulin Treatment for Sepsis<strong> </strong>

Therapeutic Strategies Targeting Mitochondrial Dysfunction in Sepsis-induced Cardiomyopathy

Contact Info

Product

Resources

About