Ventricular function, hemodynamics, and oxygen consumption during infusions of blood and glucose-insulin-potassium...

We have studied the acute effects of blood and glucose-insulin-potassium (GIK) infusions during endotoxin shock in dogs. In a first group (n = 7) we have compared the effects of blood transfusions with those of GIK. Both infusions increased left-ventricular end-diastolic pressure (LVEDP), end-diastolic diameter, mean systemic blood pressure, and cardiac output; but with GIK cardiac output rose more and left-ventricular dP/dt (LV dP/dt) also increased. During GIK end-systolic diameter decreased while it increased during blood transfusion. Peripheral resistance declined after GIK. The hemodynamic effects were of short duration. Oxygen consumption and arterial lactate increased after GIK, while serum phosphate decreased. In a second group (n = 9) we have studied the relationship between changes in serum osmolarity, hematocrit, cardiac output, and LV dP/dt during infusions of either GIK, glucose 50%, or sorbitol 50%. We found a close relationship between changes in serum osmolality, cardiac output, and LV dP/dt. We conclude that GIK has positive inotropic action, probably because it increases serum osmolality. Metabolic effects of GIK probably do not contribute to its early action.