Related Experiment Video

Updated: Aug 9, 2026

Improving IV Insulin Administration in a Community Hospital
12:08

Improving IV Insulin Administration in a Community Hospital

Published on: June 11, 2012

Cardiac arrest: a late complication of glucose-insulin-potassium (GIK) therapy

D Simes1

  • 1Department of Intensive Care Medicine, Fremantle Hospital, Fremantle, WA, Australia.

Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
|April 14, 2006
PubMed

Insights

Rebound hyperkalaemia after glucose-insulin-potassium (GIK) infusion caused cardiac arrest in a patient post-surgery. Successful resuscitation highlights potential GIK infusion hazards, even as its use expands.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Cardiovascular Surgery

Background:

  • Glucose-insulin-potassium (GIK) infusions are increasingly used for myocardial protection during cardiac surgery and in managing myocardial infarction.
  • Potential applications include treating refractory dysrhythmias and myocardial preservation in brain-dead patients.

Purpose of the Study:

  • To report a case of rebound hyperkalaemia and subsequent cardiac arrest following discontinuation of a GIK infusion.
  • To highlight the potential hazards associated with GIK infusions.

Main Methods:

  • A case report detailing a patient experiencing ventricular standstill after a GIK infusion was stopped post-re-do aortic valve surgery.
  • Clinical monitoring and successful resuscitation protocols were employed.

Main Results:

  • The patient developed rebound hyperkalaemia four hours after discontinuing the GIK infusion.
  • This hyperkalaemia led to ventricular standstill, requiring successful resuscitation.

Conclusions:

  • GIK infusions, while beneficial, carry significant risks, including potentially fatal rebound hyperkalaemia and cardiac arrest.
  • Clinicians must be vigilant regarding GIK infusion management and potential adverse events.

Related Concept Videos

Diabetic Ketoacidosis ll: Pathophysiology01:22

Diabetic Ketoacidosis ll: Pathophysiology

Diabetic ketoacidosis (DKA) is a metabolic emergency characterized by hyperglycemia, ketonemia, and metabolic acidosis. It results from severe insulin deficiency and an excess of counterregulatory hormones, leading to uncontrolled lipolysis, ketogenesis, and widespread electrolyte and fluid disturbances.Pathophysiology The central event in DKA is a profound loss of insulin action. Without insulin, glucose uptake in insulin-dependent tissues is impaired, while hepatic glucose production...
Diabetic Ketoacidosis l: Introduction01:25

Diabetic Ketoacidosis l: Introduction

DefinitionDiabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes mellitus, characterized by a triad of hyperglycemia (blood glucose >250 mg/dL), ketonemia or ketonuria, and metabolic acidosis (arterial pH <7.30 and serum bicarbonate <18 mEq/L). It results from insulin deficiency combined with elevated levels of counterregulatory hormones—glucagon, catecholamines, cortisol, and growth hormone—leading to increased lipolysis, hepatic ketone production, and...
Complications of Diabetes Mellitus01:22

Complications of Diabetes Mellitus

Diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to insulin deficiency, resistance, or both. Prolonged hyperglycemia disrupts metabolic homeostasis and leads to acute and chronic complications.Acute ComplicationsAcute complications result from sudden metabolic imbalance.Diabetic ketoacidosis (DKA) mainly appears in type 1 diabetes but may also develop in type 2 diabetes, particularly under extreme stress. It arises from severe insulin deficiency,...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Hypoglycemia01:26

Hypoglycemia

Hypoglycemia is a blood glucose level below 70 mg/dL. It commonly occurs in individuals using insulin or insulin-secreting drugs, but may also arise in non-diabetic conditions. People with type 1 diabetes are at the highest risk because they depend on exogenous insulin. People with type 2 diabetes are also at risk, especially when treated with insulin or medications such as sulfonylureas, which increase insulin release regardless of blood glucose levels. It develops when insulin levels exceed...
Hyperglycemia01:29

Hyperglycemia

Hyperglycemia is an abnormally high blood glucose level. It is diagnosed by fasting glucose ≥126 mg/dL, 2-hour oral glucose tolerance test (or OGTT) ≥200 mg/dL, random glucose ≥200 mg/dL with symptoms, or HbA1c ≥6.5%. However, HbA1c results may be unreliable in certain conditions, such as anemia or hemoglobinopathies, and the diagnosis should be confirmed unless classic symptoms are present. Postprandial hyperglycemia is typically considered significant when glucose levels exceed 180 mg/dL two...