| Objective: To investigate the effect of glucose - insulin - potassium (GIK) on multiple organs function and its mechanism
in patients undergoing cardiopulmonary bypass (CPB). Methods:Forty hundred patients undergoing mitral valve replacement were
randomly divided into GIK group (n=21) and control group (n=19). The GIK group received a central GIK infusion consisting of 500ml
of 20% glucose, 33IU insulin，30mmol of potassium chloride (KCl)) run at 60ml.h-1 starting before induction of anesthesia and finishing
six hours following release of the AXC. The control group received equivalent 0.9% Sodium chloride. In the preoperative, postoperative
12h and 24h, determination of myocardial enzymes, hepatic function and renal function were collected. Arterial blood samples were
obtained respectively from patients of the two groups before the operation, after anesthetic, CPB15min, 5min following release of AXC,
the end of CPB, 30min，6h,12h,24h following the end of operation. The levels of CRP, IL-1, IL-10 TNF-α, glucocorticoids and
epinephrine were measured. Results: AST, CK, LDH, CK-MB, ALT, TBA, BUN, CR of the patients in GIK group at post-operative 12,
24h were lower than those of control group. The level of CRP, IL-1, and TNF-α of GIK group were lower than that of control group at
the period of CPB and postoperation, and the level of IL-10 of GIK group was higher than that of control group at the same time. The
level of blood glucocorticoid of GIK group was lower than that of control group after the end of CPB, but the level of blood epinephrine
of GIK group was higher than that of control at the same time. Conclusion: GIK therapy during the CPB period can significantly improve
the multiple organs function, and the mechanism may be related to reducing the inflammatory response and the stress state. |
