Effectiveness of glucose-insulin–potassium infusion for myocardial protection in non-diabetic patients during adult cardiac surgery

Abstract

Background: Glucose-insulin-potassium (GIK) infusion is most commonly used in diabetic patients during cardiopulmonary bypass. Many studies suggest that the use of GIK infusion has beneficial outcomes mainly in myocardial protection, as myocardial protection is the main goal of Perfusionist during bypass surgery. In Pakistan, GIK is used normally in the diabetic patient as it has a good effect on insulin maintenance. Most surgeons use GIK in diabetic patients but many of the studies suggest that it has good post-op outcomes especially in myocardial protection. Method: This was an observational cross-sectional study conducted for 6 months, from November 2019 to April 2020 at the Pakistan Institute of medical sciences department of Cardiac surgery. Ethical approval was taken from the hospital ethical committee. It was consisting of 80 patients, 40 from group A (GIK infused) and 40 from group B (GIK non-infused) by using the Non-probability convenient sampling technique. Data was collected through pre-structured Performa. Results: In the early postoperative period, peak CKMB levels were high in the Non-GIK group (62.7375± 19.75393IU/L) versus (54.0005±11.41493IU/L) in the GIK group (p-value 0.000). Mean ventilation time in the GIK group was (10.85 ±6.302) hours versus (12.15 ±7.814) hours in the non-GIK group (p< 0.001). Similarly, ICU stay period was also shorter in the GIK group is (3.50 ±1.013) and in the non-GIK group is (3.50 ±0.906) (p>0.001). Conclusion: Glucose-insulin-potassium (GIK) infusion has a beneficial role in myocardial protection and is associated with better post-operative outcomes without increasing the risk of non-cardiac complications.