GLUCOSE-INSULIN-POTASSIUM (GIK) PREVENTS DERANGEMENT OF MYOCARDIAL-METABOLISM IN BRAIN-DEAD PIGS

Brain death is associated with neuroendocrine changes resulting in red uced myocardial glycogen content. The purpose of this study was to inv estigate the effects of glucose-insulin-potassium (GIK), on myocardial metabolism in brain-dead pigs. Sixteen brain-dead pigs were given GIK infusion (n = 8), or Ringer solution (n = 8). At end-point (7 h post brain death) arterial concentrations and myocardial arteriovenous (a-v ) concentration differences of glucose, lactate and free fatty acids ( FFA) were assessed, and myocardial biopsy specimens were taken from th e right atrium and left ventricle. Biopsies were also taken from five normal pigs. Myocardial glycogen content in the GIK group was signific antly higher compared to the control group, but comparable to the non- brain-dead animals. There was a higher and significant myocardial upta ke of glucose and lactate in the GIK group compared to the controls. P lasma levels of FFA were significantly lower in the GIK group, and the myocardial uptake of FFA was 5 times higher in the control group comp ared to the GIK group. There were no significant differences in hemody namic variables among the groups. In conclusion, intravenous supply of GIK to brain-dead pigs results in increased myocardial glycogen conte nt and seems to prevent abnormal myocardial metabolism, which may have clinical implications for the myocardial protection of donor hearts.