The purpose of this study is to evaluate the cardioprotective effects of a short term infusion of glucose-insulin-potassium (GIK) during heart surgery.
Cardiac surgery with cardiopulmonary bypass and ischemic cardiac arrest is associated with a wide spectrum of perioperative myocardial ischemic-reperfusion injuries resulting in significant cardiac morbidity, namely contractile dysfunction, myocardial infarction, and low cardiac output syndrome requiring prolonged intensive care and hospital stay. The infusion of glucose-insulin-potassium (GIK) is one of the oldest cardioprotective interventions during cardiac surgery. Although experimental evidence is strong, clinical data remain conflicting. We will investigate the impact of short term GIK on the extent of myocardial injuries as well as on the left-ventricular systolic and diastolic function in 2 high-risk groups of cardiac surgical patients: Patients with cardiac dysfunction undergoing aortocoronary bypass surgery and patients with severe aortic stenosis.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
200
20 IU of insulin and 10 mM of KCl mixed with 50 ml of 40% Glucose. Administration of 0.8 ml/kg/h over 60 min before aortic cross-clamping
60 ml of isotonic saline. Administration of 0.8 ml/kg/h over 60 min before aortic cross-clamping
Geneva University Hospital
Geneva, Canton of Geneva, Switzerland
Cardiocentro
Lugano, Canton Ticino, Switzerland
Postcardiotomy ventricular dysfunction
Time frame: 48h postoperative
Systolic and diastolic cardiac function using transoesophageal echocardiography
Time frame: intraoperative
Hypo-/hyperglycemia Hypo-/hyperkaliemia
Time frame: intraoperative
Serious cardiovascular adverse events (myocardial infarction, cardiac arrhythmia, low cardiac output, stroke)
Time frame: 48 postoperative
Serum troponin and creatinine kinase
Time frame: Intraoperative - 48 h postoperative
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