2004, Number 3
<< Back Next >>
Arch Cardiol Mex 2004; 74 (3)
On metabolic therapeutics G-I-K in surgery of cardiac patients
Micheli A, Medrano GA
Language: Spanish
References: 36
Page: 215-219
PDF size: 90.62 Kb.
ABSTRACT
The basic principles of the metabolic therapeutics with glucose-insulin-potassium solutions, already proposed by Dr. Demetrio Sodi Pallares, are exposed. Chronologic succession of this treatment during the preoperative, transoperative and postoperative phases of heart surgery, as well as some personal observations of one of the authors, are described. The glucose-insulin-potassium solution is a powerful system, providing very useful energy to protect the injured myocardium during cardiovascular surgery. Many publications support this assertion. The most recent ones indicate a reduction of low output syndromes due to interventions on coronary arteries, as well as a significant diminution of circulating fatty acids after primary angioplasty. The mentioned solution, in higher concentrations than the initial one, could become routine therapeutics in medicine and surgery centers, in general.
REFERENCES
Larcan A, Huriet C: L’électrocardiogramme dysmétabolique. París. Ed. Masson & Cie, 1959.
Olson RE: Metabolic interventions in the treatment of infarcting myocardium. Circulation 1969; 40(Suppl 4):195-201.
De Micheli A: Enfoque racional de ciertos aspectos diagnósticos y terapéuticos del infarto del miocardio. Arch Inst Cardiol Mex 1971; 41(3): 340-356.
Smith AE, Luten D: Study of glucose therapy in heart failure in advanced cardiac disease. Am Heart J 1934; 9: 437-446.
Olascoaga JQ: Principales acciones fisiológicas de la combinación azúcar-insulina en terapéutica cardíaca. (Tesis recepcional). México. Facultad de Medicina, UNAM, 1933.
Kisthinios N: Le traitement des cardiopathies par l’association sucre-insuline. París, JB Baillière et Fils, 1933.
McAllen PM: Myocardial changes occurring in potassium deficiency. Br Heart J 1955; 17: 5-14.
Selye H: The chemical prevention of cardiac necrosis. Nueva York. The Ronald Press Co, 1958.
Sodi PD, de Micheli A: Un tentativo di reintegrazione ionica cellulare in alcune malattie cardiovascolari. Atti Acc Med Lombarda 1962; 17(4): 509-519.
Haneda T, Ganz W, Lee T, Katz J: Reduction of myocardial oxygen demand by glucose-insulin-potassium (GIK). Circulation 1974; 50(Suppl III): 102.
Opie LH: Metabolism of free fatty acids, glucose, and catecholamines in acute myocardial infarction. Am J Cardiol 1975;36: 938-953.
Opie L H, Bricknel OL: Role of glycolitic flux in effect of glucose in decreasing fatty-acid-induced release of lactate dehydrogenase from isolated coronary ligated rat heart. Cardiovasc Res 1979; 13: 693-702.
12a.Toyama T, Hoshizaki H, Seki R, Isobe N, Adachi H, Naito S, et al: Evaluation of salvaged myocardium after acute myocardial infarction using single emission computed tomography after 201TI-glucose-insulin infusion. Circ J 2004; 68(4): 348-354.
Moffitt EA, Rosevear JW, Molnar GD, McGoon DC: Effect of glucose, insulin, potassium solution on ketosis following cardiac surgery. Anesth Analg 1971; 50:291-297.
Moffitt EA, Rosevear JW, McGoon DC: Myocardial metabolism in children having open-heart surgery. JAMA 1970; 211: 1518-1524.
Moffitt EA, Rosevear JW, McGoon DC: Myocardial metabolism during and after mitral valve replacement. Ann Thorac Surg 1970; 10: 169-179.
Oldfield GS, Commerford PJ, Opie HL: Effect of preoperative glucose-insulin-potassium on myocardial glycogen levels and on complications of mitral valve replacement. J Thorac Cardiovasc Surg 1986; 91: 874-876.
Gradinac S, Coleman GM, Taegtmeyer H, Sweeney MS, Frazier OH: Improved cardiac function with glucose-insulin-potassium after aortocoronary bypass grafting. Ann Thorac Surg 1989; 48: 484-489.
Girard C, Quentin P, Bouvier H, Blanc P, Bastien O, Lehot JJ, et al: Glucose and insulin supply before cardiopulmonary bypass in cardiac surgery: a double-blind study. Ann Thorac Surg 1992; 54: 259-263.
Svedjeholm R, Håkanson E, Vanhanen I: Rationale for metabolic support with amino acids and glucose-insulin-potassium (GIK) in cardiac surgery. Ann Thorac Surg 1995; 59: S15-22.
Svedjeholm R, Huljebrant I, Håkanson E, Vanhanen I: Glutamate and high dose glucose-insulin-potassium (G-I-K) in the treatment of severe cardiac failure after cardiac operations. Ann Thorac Surg 1995; 59: S23-30.
Lazar HL, Zhang X, Rivers S, Bernard S, Shemin RJ: Limiting ischemic myocardial damage using glucose-insulin-potassium solutions. Ann Thorac Surg 1995; 60: 411-416.
Lazar HL, Philippides G, Fitzgerald C, Lancaster D, Shemin RJ, Apstein C: Glucose-insulin-potassium solutions enhance recovery after urgent coronary artery bypass grafting. J Thorac Cardiovasc Surg 1997; 113: 354-362.
Lazar HL, Chipkin S, Philippides G, Bao Y, Apstein C: Glucose-insulin-potassium solutions improve outcomes in diabetic who have coronary artery operations. Ann Thorac Surg 2000; 70: 145-150.
Besogul Y, Tunerir S, Asian R, Isiksoy S, Colak O, Kural T: Clinical, biochemical and histochemical assessment of pretreatment with glucose-insulin-potassium for patients undergoing mitral valve replacement in the third and fourth group of the New York Heart Association. Cardiovasc Surg 1999; 7(6): 645-650.
Dainese L, Polvani GL, Fumero A, Spirito R, Alamanni F, Agrifoglio M, et al: Glucosa-insulina-potassio (GIK) nella riduzione dell’ischemia miocardica acuta dopo intervento di bypass aorto-coronario. G Ital Cardiol 1999; 29(5): 575-579.
Harold L, Lazar MD: Enhanced preservation of acutely ischemic myocardium using glucose-insulin-potassium solution. J Cardiovasc Surg 1994; 9(Suppl): 474-478.
Cutler GD, Arellano UJ: Solución de glucosa, insulina y potasio, en el tratamiento del íleo postoperatorio. Observación clínica preliminar. Cirujano General 2001; 23(4): 296-300.
Szabó Z, Arnqvist H, Håkanson E, Svedjeholm R: Effects of high-dose glucose-insulin-potassium on myocardial metabolism after coronary surgery in patients with Type II diabetes. Clin Sci 2001; 101: 37-43.
Szabó Z, Håkanson E, Maros T, Svedjeholm R: High-dose glucose-insulin-potassium after cardiac surgery: a retrospective analysis of clinical safety issues. Acta Anaesthesiol Scand 2003; 47: 383-390.
Quin DW, Pagano D, Bonser RS: Glucose insulin potassium therapy reduces the incidence of low cardiac output syndrome following coronary artery surgery. Circulation 2003; 108(No. 17 Suppl): IV-510 No. 2325.
Addo TA, Keeley EC, de Lemos JA, Dobbins RL, Baker SH, Shay DR, et al: Suppression of circulating free fatty acids (FFAs) associated with glucose-insulin-potassium (GIK) infusion in the setting of primary angioplasty for acute myocardial infarction. Circulation 2003; 108 (No. 17 Suppl): IV-673 No. 3060.
Apstein CS, Opie LH: Glucose-insulin-potassium (GIK) for acute myocardial infarction: a negative study with a positive value. Cardiovasc Drugs Ther 1999; 13(3): 185-189.
Díaz R, Paolasso EA, Piegas LS, Tajer CD, Gil MM, Corvalán R, et al. Metabolic modulation of acute myocardial infarction. The ECLA glucose-insulin-potassium pilot trial. Circulation 1998; 98: 2227-2234.
Ceremuzynski L, Budoj A, Czapiel A, Burzkowski T, Achremczyk P, Smielakkorombel W, et al: Low-dose glucose-insulin-potassium is ineffective in acute myocardial infarction: Results of a randomized multicenter Pol-GIK trial. Cardiovasc Drugs Ther 1999; 13(3): 191-200.
De Micheli A: La terapéutica metabólica con glucosa-insulina-potasio. Bosquejo histórico. Arch Inst Cardiol Mex 2000; 70(6): 609-615.