Role of Glucose-Insulin-Potassium solution for myocardial protection during open-heart surgery

Abstract

The purpose of this review was to verify the function and potential mechanisms of glucose-insulin-potassium (GIK) solution infusion in cardiac surgery concerning cardiac protection. Myocardial damage is associated with cardiac surgical procedures involving hypothermic cardiac arrest and cardiopulmonary bypass (CPB). One of the most critical targets for cardiac surgery during anesthesia is to reduce myocardial damage. In terms of cardiac morbidity and mortality, effective intraoperative cardiac protection primarily defines postoperative outcomes. Well studied techniques and recognized cardiac safety methods do have some drawbacks in their functions. One solution to this issue is increased metabolic assistance, intended to minimize perceived ischemic injury. In practical use, many modern techniques such as glucose insulin potassium infusion are still restricted in terms of their added efficacy in cardiac protection. Providing glucose and insulin to the critically ischaemic cell has been hypothesized to have several beneficial effects, it increases the production of anaerobic adenosine triphosphate (ATP) despite the inhibition of fatty acid metabolism while retaining a defensive role on the threatened cell membrane.