Document Detail


Enhanced ventricular recovery from high dose glucose, insulin and potassium with cardiopulmonary bypass support prior to cardioplegic arrest.
MedLine Citation:
PMID:  8398187     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The concept that a beneficial preconditioning effect in ventricular recovery exists using high dose glucose (0.5 mg/kg), insulin (0.3 unit/kg), and potassium (0.2 mmol/kg) (GIK) with 20 min of normothermic cardiopulmonary bypass support (CPB) prior to 60 min of cardioplegic arrest (CA) was tested using 32 mongrel dogs divided into four subset test groups. Group 1 was given GIK and 20 min of CPB prior to CA, Group 2 was given GIK systemically over 10 min but no CPB prior to CA, Group 3 underwent 20 min of CPB without GIK and Group 4 was the control group with no GIK and no CPB assist. To focus specifically on in vivo ventricular recovery, dP/dT (mmHg/sec), developed pressure (dP) (mmHg), and segmental shortening (SS) (%) were measured prior to CPB, then 15, 30, 60, and 90 min after weaning from CPB, while left atrial pressure was kept constant. The average dP/dT (% recovery) at 60 min in Group 1 was 1,454 (122%) and significantly higher (P < or = 0.05) than Groups 2: 1,189 (99%), 3: 1,027 (79%) and 4: 1,030 (82%). Developed pressure at 90 min (% recovery) in Group 1, 88 (111%) was also better than Groups 3, 74 (86%), and 4, 72 (87%) (P < or = 0.05). Segmental shortening (% recovery) at 30 min was better in Group 1 (94%) than in Groups 2 (59%), 3 (73%) and 4 (68%). We conclude that GIK added to 20 min of CPB support prior to cardioplegic arrest enhances post CPB ventricular recovery and weaning from CPB.
Authors:
H Nishida; R K Grooters; K C Thieman; H Soltanzadeh; R F Schneider; D F Merkley
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  7     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1993  
Date Detail:
Created Date:  1993-11-16     Completed Date:  1993-11-16     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  409-13     Citation Subset:  IM    
Affiliation:
Department of Surgery, Iowa Methodist Medical Center, Des Moines.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardioplegic Solutions / pharmacology*
Cardiopulmonary Bypass*
Dogs
Glucose / pharmacology*
Heart Arrest, Induced / methods*
Insulin / pharmacology*
Myocardial Contraction / drug effects*
Potassium / pharmacology*
Tissue Preservation / methods
Chemical
Reg. No./Substance:
0/Cardioplegic Solutions; 0/glucose-insulin-potassium cardioplegic solution; 11061-68-0/Insulin; 50-99-7/Glucose; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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