Experience using high-dose glucose-insulin-potassium (GIK) in critically ill patients

Area of Science:

• Critical Care Medicine
• Cardiology
• Endocrinology

Background:

• Glucose-Insulin-Potassium (GIK) therapy is utilized to improve cardiac function in critically ill patients.
• The safety and efficacy of high-dose GIK require further evaluation.

Purpose of the Study:

• To audit the safety and hemodynamic effects of Glucose-Insulin-Potassium (GIK) therapy.
• To assess the impact of GIK on catecholamine dosage in critically ill patients.

Main Methods:

• A retrospective audit of GIK use in an adult intensive care unit (ICU) was performed.
• Data collected included ICU survival, cardiac index (CI), blood lactate levels, and catecholamine discontinuation.
• Adverse events such as hypoglycemia, hyperglycemia, hypokalemia, and hyperkalemia were recorded.

Main Results:

• Of 85 patients treated with GIK, 15.3% survived ICU stay and 10.5% were discharged home.
• A trend towards improved CI and lactate levels was observed in survivors, with reduced catecholamine dosing.
• Inotropes were discontinued in 54% of patients; metabolic abnormalities were identified and managed, with no measurable harm.

Conclusions:

• High-dose GIK can be safely administered to critically ill patients with careful monitoring of glucose and potassium levels.
• GIK therapy demonstrated association with improved CI and blood lactate levels.
• Prospective studies are needed to evaluate the impact of GIK on survival.