Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations
Background. This study was undertaken to determine whether glucose-insulin-potassium (GIK) would improve myocardial performance and limit morbidity after coronary artery bypass grafting in diabetic patients. Methods. Forty consecutive coronary artery bypass grafting patients with medically treated d...
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| Veröffentlicht in: | The Annals of thoracic surgery 2000-07, Vol.70 (1), p.145-150 |
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| creator | Lazar, Harold L Chipkin, Stuart Philippides, George Bao, Yusheng Apstein, Carl |
| description | Background. This study was undertaken to determine whether glucose-insulin-potassium (GIK) would improve myocardial performance and limit morbidity after coronary artery bypass grafting in diabetic patients.
Methods. Forty consecutive coronary artery bypass grafting patients with medically treated diabetes mellitus were prospectively randomly assigned to either a GIK group (n = 20; 500 mL D
5W + 80 U regular insulin + 40 mEq KCl 30 mL/hour) or a no-GIK group (n = 20; D
5W at 30 mL/hour). The GIK was begun at anesthetic induction and continued for 12 hours postoperatively.
Results. Patients treated with GIK had higher postoperative cardiac indices (2.88 ± 0.50 versus 2.20 ± 0.39 L/minute per square meter;
p < 0.0001), lower inotrope scores (0.40 ± 0.68 versus 1.25 ± 1.44;
p = 0.05), less weight gain (5.80 ± 3.76 versus 13.85 ± 6.52 pounds;
p < 0.0001), and had shorter times of ventilator support (8.35 ± 2.60 versus 13.45 ± 7.33 hours;
p = 0.0128). They had a significantly lower prevalence of atrial fibrillation (15% versus 60%;
p = 0.003), and shorter hospital stays (6.70 ± 1.52 versus 10.15 ± 6.62 days;
p = 0.02).
Conclusions. Substrate enhancement with GIK in diabetic patients improved myocardial performance and resulted in faster recovery after coronary artery bypass grafting. |
| doi_str_mv | 10.1016/S0003-4975(00)01317-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_71281219</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0003497500013175</els_id><sourcerecordid>71281219</sourcerecordid><originalsourceid>FETCH-LOGICAL-c425t-6f95126abb928f1b7a1fe2623d3cc51f2da7be9f53ee005225e0f102474ed3873</originalsourceid><addsrcrecordid>eNqFkMFO3DAQhq2KqizbPgJVDgjRQ6jHiZP1CSEESyUkDm3PluOMhaskXjwJiLfHu1lRbpxG9nwz8-tj7Bj4OXCofv7mnBd5qWp5xvkPDgXUufzEFiClyCsh1QFbvCGH7IjoX3qK1P7CDoErAZVSC4brbrKBMPcDTZ0f8k0YDZGf-oxCN40-DJT5fhPDE2ZhGm3oMX0MWetNg6O3lD0_hOzBpLYNMQwmvmQmjphK2GA0uw1f2WdnOsJv-7pkf2-u_1zd5nf3619Xl3e5LYUc88opCaIyTaPEykFTG3AoKlG0hbUSnGhN3aByskDkXAohkTvgoqxLbItVXSzZ6bw35X2ckEbde7LYdWbAMJGuQaxAgEqgnEEbA1FEpzfR9ym7Bq63fvXOr97K05zrnV8t09z3_YGp6bF9NzULTcDJHjBkTeeiGayn_1xZyEptg17MGCYbTx6jJutxsNj6iHbUbfAfJHkFhV6ZOg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>71281219</pqid></control><display><type>article</type><title>Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Lazar, Harold L ; Chipkin, Stuart ; Philippides, George ; Bao, Yusheng ; Apstein, Carl</creator><creatorcontrib>Lazar, Harold L ; Chipkin, Stuart ; Philippides, George ; Bao, Yusheng ; Apstein, Carl</creatorcontrib><description>Background. This study was undertaken to determine whether glucose-insulin-potassium (GIK) would improve myocardial performance and limit morbidity after coronary artery bypass grafting in diabetic patients.
Methods. Forty consecutive coronary artery bypass grafting patients with medically treated diabetes mellitus were prospectively randomly assigned to either a GIK group (n = 20; 500 mL D
5W + 80 U regular insulin + 40 mEq KCl 30 mL/hour) or a no-GIK group (n = 20; D
5W at 30 mL/hour). The GIK was begun at anesthetic induction and continued for 12 hours postoperatively.
Results. Patients treated with GIK had higher postoperative cardiac indices (2.88 ± 0.50 versus 2.20 ± 0.39 L/minute per square meter;
p < 0.0001), lower inotrope scores (0.40 ± 0.68 versus 1.25 ± 1.44;
p = 0.05), less weight gain (5.80 ± 3.76 versus 13.85 ± 6.52 pounds;
p < 0.0001), and had shorter times of ventilator support (8.35 ± 2.60 versus 13.45 ± 7.33 hours;
p = 0.0128). They had a significantly lower prevalence of atrial fibrillation (15% versus 60%;
p = 0.003), and shorter hospital stays (6.70 ± 1.52 versus 10.15 ± 6.62 days;
p = 0.02).
Conclusions. Substrate enhancement with GIK in diabetic patients improved myocardial performance and resulted in faster recovery after coronary artery bypass grafting.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(00)01317-5</identifier><identifier>PMID: 10921699</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardioplegic Solutions - administration & dosage ; Coronary Artery Bypass ; Diabetes Complications ; Female ; Glucose - administration & dosage ; Hormones. Endocrine system ; Humans ; Insulin - administration & dosage ; Male ; Medical sciences ; Pharmacology. Drug treatments ; Postoperative Complications - epidemiology ; Postoperative Complications - prevention & control ; Potassium - administration & dosage ; Prospective Studies ; Treatment Outcome</subject><ispartof>The Annals of thoracic surgery, 2000-07, Vol.70 (1), p.145-150</ispartof><rights>2000 The Society of Thoracic Surgeons</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-6f95126abb928f1b7a1fe2623d3cc51f2da7be9f53ee005225e0f102474ed3873</citedby><cites>FETCH-LOGICAL-c425t-6f95126abb928f1b7a1fe2623d3cc51f2da7be9f53ee005225e0f102474ed3873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003497500013175$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1435697$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10921699$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lazar, Harold L</creatorcontrib><creatorcontrib>Chipkin, Stuart</creatorcontrib><creatorcontrib>Philippides, George</creatorcontrib><creatorcontrib>Bao, Yusheng</creatorcontrib><creatorcontrib>Apstein, Carl</creatorcontrib><title>Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. This study was undertaken to determine whether glucose-insulin-potassium (GIK) would improve myocardial performance and limit morbidity after coronary artery bypass grafting in diabetic patients.
Methods. Forty consecutive coronary artery bypass grafting patients with medically treated diabetes mellitus were prospectively randomly assigned to either a GIK group (n = 20; 500 mL D
5W + 80 U regular insulin + 40 mEq KCl 30 mL/hour) or a no-GIK group (n = 20; D
5W at 30 mL/hour). The GIK was begun at anesthetic induction and continued for 12 hours postoperatively.
Results. Patients treated with GIK had higher postoperative cardiac indices (2.88 ± 0.50 versus 2.20 ± 0.39 L/minute per square meter;
p < 0.0001), lower inotrope scores (0.40 ± 0.68 versus 1.25 ± 1.44;
p = 0.05), less weight gain (5.80 ± 3.76 versus 13.85 ± 6.52 pounds;
p < 0.0001), and had shorter times of ventilator support (8.35 ± 2.60 versus 13.45 ± 7.33 hours;
p = 0.0128). They had a significantly lower prevalence of atrial fibrillation (15% versus 60%;
p = 0.003), and shorter hospital stays (6.70 ± 1.52 versus 10.15 ± 6.62 days;
p = 0.02).
Conclusions. Substrate enhancement with GIK in diabetic patients improved myocardial performance and resulted in faster recovery after coronary artery bypass grafting.</description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardioplegic Solutions - administration & dosage</subject><subject>Coronary Artery Bypass</subject><subject>Diabetes Complications</subject><subject>Female</subject><subject>Glucose - administration & dosage</subject><subject>Hormones. Endocrine system</subject><subject>Humans</subject><subject>Insulin - administration & dosage</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pharmacology. Drug treatments</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - prevention & control</subject><subject>Potassium - administration & dosage</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMFO3DAQhq2KqizbPgJVDgjRQ6jHiZP1CSEESyUkDm3PluOMhaskXjwJiLfHu1lRbpxG9nwz8-tj7Bj4OXCofv7mnBd5qWp5xvkPDgXUufzEFiClyCsh1QFbvCGH7IjoX3qK1P7CDoErAZVSC4brbrKBMPcDTZ0f8k0YDZGf-oxCN40-DJT5fhPDE2ZhGm3oMX0MWetNg6O3lD0_hOzBpLYNMQwmvmQmjphK2GA0uw1f2WdnOsJv-7pkf2-u_1zd5nf3619Xl3e5LYUc88opCaIyTaPEykFTG3AoKlG0hbUSnGhN3aByskDkXAohkTvgoqxLbItVXSzZ6bw35X2ckEbde7LYdWbAMJGuQaxAgEqgnEEbA1FEpzfR9ym7Bq63fvXOr97K05zrnV8t09z3_YGp6bF9NzULTcDJHjBkTeeiGayn_1xZyEptg17MGCYbTx6jJutxsNj6iHbUbfAfJHkFhV6ZOg</recordid><startdate>20000701</startdate><enddate>20000701</enddate><creator>Lazar, Harold L</creator><creator>Chipkin, Stuart</creator><creator>Philippides, George</creator><creator>Bao, Yusheng</creator><creator>Apstein, Carl</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000701</creationdate><title>Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations</title><author>Lazar, Harold L ; Chipkin, Stuart ; Philippides, George ; Bao, Yusheng ; Apstein, Carl</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-6f95126abb928f1b7a1fe2623d3cc51f2da7be9f53ee005225e0f102474ed3873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardioplegic Solutions - administration & dosage</topic><topic>Coronary Artery Bypass</topic><topic>Diabetes Complications</topic><topic>Female</topic><topic>Glucose - administration & dosage</topic><topic>Hormones. Endocrine system</topic><topic>Humans</topic><topic>Insulin - administration & dosage</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pharmacology. Drug treatments</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - prevention & control</topic><topic>Potassium - administration & dosage</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lazar, Harold L</creatorcontrib><creatorcontrib>Chipkin, Stuart</creatorcontrib><creatorcontrib>Philippides, George</creatorcontrib><creatorcontrib>Bao, Yusheng</creatorcontrib><creatorcontrib>Apstein, Carl</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lazar, Harold L</au><au>Chipkin, Stuart</au><au>Philippides, George</au><au>Bao, Yusheng</au><au>Apstein, Carl</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>2000-07-01</date><risdate>2000</risdate><volume>70</volume><issue>1</issue><spage>145</spage><epage>150</epage><pages>145-150</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. This study was undertaken to determine whether glucose-insulin-potassium (GIK) would improve myocardial performance and limit morbidity after coronary artery bypass grafting in diabetic patients.
Methods. Forty consecutive coronary artery bypass grafting patients with medically treated diabetes mellitus were prospectively randomly assigned to either a GIK group (n = 20; 500 mL D
5W + 80 U regular insulin + 40 mEq KCl 30 mL/hour) or a no-GIK group (n = 20; D
5W at 30 mL/hour). The GIK was begun at anesthetic induction and continued for 12 hours postoperatively.
Results. Patients treated with GIK had higher postoperative cardiac indices (2.88 ± 0.50 versus 2.20 ± 0.39 L/minute per square meter;
p < 0.0001), lower inotrope scores (0.40 ± 0.68 versus 1.25 ± 1.44;
p = 0.05), less weight gain (5.80 ± 3.76 versus 13.85 ± 6.52 pounds;
p < 0.0001), and had shorter times of ventilator support (8.35 ± 2.60 versus 13.45 ± 7.33 hours;
p = 0.0128). They had a significantly lower prevalence of atrial fibrillation (15% versus 60%;
p = 0.003), and shorter hospital stays (6.70 ± 1.52 versus 10.15 ± 6.62 days;
p = 0.02).
Conclusions. Substrate enhancement with GIK in diabetic patients improved myocardial performance and resulted in faster recovery after coronary artery bypass grafting.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10921699</pmid><doi>10.1016/S0003-4975(00)01317-5</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Biological and medical sciences Cardioplegic Solutions - administration & dosage Coronary Artery Bypass Diabetes Complications Female Glucose - administration & dosage Hormones. Endocrine system Humans Insulin - administration & dosage Male Medical sciences Pharmacology. Drug treatments Postoperative Complications - epidemiology Postoperative Complications - prevention & control Potassium - administration & dosage Prospective Studies Treatment Outcome |
| title | Glucose-insulin-potassium solutions improve outcomes in diabetics who have coronary artery operations |
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