Metabolic effect of glucose, insulin and potassium cardioplegia

Glucose-insulin-potassium (GIK) solution is widely used as a cardioplegic infusate for myocardial protection during aortic cross-clamping, to obtain rapid diastolic arrest and preservation of energy stores. Nine male patients with aorto-coronary bypass grafting procedure were studied with regard to the metabolic influence of GIK cardioplegia. Hyperglycemia was induced by the infusion of GIK solution for one week after surgery. The serum level of non-esterified fatty acid was high for one week while the triglyceride level was maintained at a high level only in the early post-operative period. Insulin, glucagon and growth hormone which influence carbohydrate and lipid metabolism were also elevated for one week after infusion of GIK solution. We conclude that the derangement of carbohydrate and lipid metabolism which is provoked by the use of GIK cardioplegia normalizes within two weeks after operation.