Home|Journals Follow on Twitter| Subscribe to List

Directory for Medical Articles
 

Open Access

1

Med Arh. 2013; 67(2): 84-87


Glucosa-Insulin-Potassium (GIK) Solution Used with Diabetic Patients Provides Better Recovery After Coronary Bypass Operations

Slavenka Straus, Vjekoslav Gerc, Mirsad Kacila, Faruk Custovic.

Cited by (1)

Abstract
Introduction: Tight blood glucose control has become a therapeutical goal for anesthetic management for patients scheduled for cardiac surgery, especially if they are diabetic patients. Aim: This study was created to confirm the benefits of intraoperative GIK solution usage during coronary bypass operation of diabetic patients. Methods: Patients with type 1 and 2 diabetes mellitus (DM) referred for coronary artery bypass grafting (CABG) were randomized to receive GIK solution (GIK study group) in the first 24 hours intraoperatively or to receive official Clinical protocol without GIK solution (non GIK control group). The primary clinical outcome was the cardiac index (CI) since it represents the most sensitive measure of cardiac work in the immediate postoperative period, and the secondary clinical outcomes were the glycemic control, insulin consumption, duration of mechanical ventilation (MV), potassium level and atrial fibrillation (AF) appearance. Results: One hundred diabetic patients, divided into two groups, were included in the study. The cardiac index did not show a significant difference, although the study group had CI with only minor variations than those of the controlled group, hence the reason we considered the study group as the more stable. The atrial fibrillation showed a difference between two groups, with 14 (28%) patients with postoperative AF in the control group compared with 3 (6%) patients with postoperative AF in the study group. As potassium values were stable in study group, we concluded that it can be one of the reasons for less postoperative AF in this group. The duration of MV showed a significant difference (0,003) between the two groups as well. In the study group the average MV time was 534,38 minutes, compared with the control group with 749,20 minutes. The average value of glucose was 11.1 mmol/l in the control group vs. 9.8 mmol/l in the study group. The study group had less insulin consumption in order to maintain target glycemia (p=0,001). In the non GIK group average insulin consumption was 44 IJ per patient vs. 28,5 IJ in the GIK group. Conclusion: Intraoperative GIK solution given to diabetic patients with CABG operation provides more stable CI, shorter time of MV, more stable values of potassium which provides normal rhythm and less AF onset, less insulin to maintain target glycemia. All the above mentioned provides more stable intraoperative hemodynamic and better recovery of diabetic patients with coronary artery bypass operations.

Key words: diabetes mellitus, coronary artery bypass operation, glucosa-insulin-potassium solution, intraoperative glucose control



Share this Article


Advertisement
Journal of Complementary Medicine Research

SUBMIT YOUR ARTICLE NOW


ScopeMed.com
ScopeMed Home
Follow ScopeMed on Twitter
BiblioCAM
Author Tools
eJPort Journal Hosting
About ScopeMed
License Information
Terms & Conditions
Privacy Policy
Suggest a Journal
Publisher Login
Contact Us

The articles in Scopemed are open access articles licensed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (https://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.
ScopeMed is a Database Service for Scientific Publications. Copyright ScopeMed Information Services.
Scopemed Buttons