GLUCOSE-INSULIN-POTASSIUM SOLUTIONS ENHANCE RECOVERY AFTER URGENT CORONARY-ARTERY BYPASS-GRAFTING

Objective: This prospective, randomized, clinical study. was undertake n to determine whether glucose-insulin-potassium solutions would benef it patients undergoing coronary artery bypass grafting because of unst able angina, Methods: The study group consisted of 30 patients with un stable angina who required coronary artery bypass grafting, In 15 pati ents, glucose-insulin-potassium solution (30% dextrose in water; K+, 8 0 mEq/L; regular insulin, 50 units) was given intravenously at 1 ml/kg per hour after induction of anesthesia and administration continued f or 12 hours after aortic unclamping. Fifteen patients in a separate gr oup received 5% dextrose in water intravenously at 50 ml/hr. Results: Patients treated with glucose-insulin-potassium solution had higher ca rdiac indices (2.8 +/- 0.1 vs 2.0 +/- 1 L/min per square meter; p < 0. 001), lower inotrope scores (0.06 +/- 0.01 vs 0.46 +/- 0.19; p = 0.041 ), and less weight gain (6.4 +/- 9 vs 11.6 +/- 1.1 pounds; p < 0.001) and had shorter times of ventilator support (8.3 +/- 0.6 vs 14.2 +/- 0 .2 hours; p = 0.003), They had a significantly lower incidence of atri al fibrillation (13.3% vs 53.3%; p = 0.020) and had shorter stays in t he intensive care unit (14.8 +/- 1.3 vs 31.6 +/- 5.2 hours; p = 0.002) and in the hospital (6.0 +/- 0.4 vs 8.0 +/- 0.7 days; p = 0.010), Con clusions: We conclude that glucose-insulin-potassium therapy enhances myocardial performance and results in faster recovery from urgent coro nary artery bypass grafting.