Document Detail

Myocardial metabolic and morphometric changes during canine endotoxin shock before and after glucose-insulin-potassium.
MedLine Citation:
PMID:  3899358     Owner:  NLM     Status:  MEDLINE    
Glucose-insulin-potassium (GIK) improves myocardial function during endotoxin shock but the mechanism of this action is not clear. We have studied in open chest dogs the effects of GIK (n = 9) on haemodynamics, myocardial biochemistry (repeated drill biopsies; glucose-6-phosphate, G-6-P; fructose-6-phosphate, F-6-P; adenosine triphosphate, ATP; creatinine phosphate, CP; glycogen) and myocardial histomorphometry. The animals were anaesthetised (etomidate 4 mg X kg-1 X h-1) and artificially ventilated (N2O:O2 = 2:1). After endotoxin (1.5 mg X kg-1) cardiac output (CO) and mean arterial pressure (MAP) fell rapidly, with a temporary recovery followed by gradual circulatory collapse. Coronary blood flow (cbf; radioactive microspheres) decreased, but this was not significant. G-6-P tended to fall, as did ATP levels while CP levels were unaltered. Histomorphometrical analysis showed myocardial cell swelling with compression of capillaries and decreased interstitial volume. GIK infusion (50% glucose, 2 g X kg-1bw, 8 mmol KCl and 3 U insulin kg-1bw) increased CO and coronary blood flow. Glycogen and G-6-P levels did not change, while F-6-P tended to increase. ATP levels were not influenced by ATP/CP ratio decreased. Myocardial cell swelling markedly decreased; average capillary cross-sectional area, as an index of capillary compression, returned to control value. In two dogs, which died before the end of the experiment, myocardial oedema, with disturbed capillary volume and reduced interstitial volume was unaltered after GIK. The initial effects of GIK are most likely due to restoration of myocardial perfusion. Improved perfusion, and the influence of elevated serum osmolality and insulin levels on excitation-contraction coupling may help to improve myocardial function.
W Bronsveld; A A van Lambalgen; D van Velzen; G C van den Bos; P A Koopman; L G Thijs
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular research     Volume:  19     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  1985 Aug 
Date Detail:
Created Date:  1985-11-04     Completed Date:  1985-11-04     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  455-64     Citation Subset:  IM    
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MeSH Terms
Capillaries / pathology
Coronary Circulation / drug effects
Glucose / metabolism,  pharmacology*
Insulin / pharmacology*
Lactates / metabolism
Myocardium / metabolism*,  pathology
Oxygen Consumption / drug effects
Potassium / pharmacology*
Shock, Septic / metabolism*,  pathology
Reg. No./Substance:
0/Lactates; 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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