J.Jpn. Surg. Soc.. 82(7): 708-716, 1981
Original article
HEMODYNAMIC AND DIURETIC EFFECTS OF GIK (GLUCOSE-INSULIN-KALIUM) TREATMENT ON EXTENSIVE BURN PATIENTS
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Department of Traumatology, Osaka University School of Medicine Hisashi Kobayashi, Toshiharu Yoshioka, Ken Maemura, Noriyoshi Ohashi, Yusuke Sawada, Tsuyoshi Sugimoto |
Sixteen patients were divided into 4 groups. Group 1 : 9 patients with 71±6% body surface area (BSA) within 48 hours post burn. Group 2 : 3 patients in group 1 complicated with septicemia. Group 3 : 3 control patients with head injury. Group 4 : 4 patients with 72±17% BSA within 48 hours post burn. The GIK solution with 100ml of 50% glucose, 75 units insulin, and 10mEq KCL was injected intravenously in group 1, group 2, and group 3, respectively. In group 4, 100ml of 50% glucose was administered. Following parameters were measured pre GIK and post GIK : blood sugar, heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), stroke volume index (SVI), total systemic peripheral resistance index (TPRI), left ventricular stroke work index (LVSWI), urine volume and urine sugar. Blood volume was measured in a patient in gorup 1 and in another patient in group 4.
In the early post burn group, GIK therapy resulted in an increase of CI (p＜0.05) induced by the elevated SVI, an increase of LVSWI (p＜0.05), and adecrease of TPRI (p＜0.05). However, GIK therapyr esulted in a minor and transient increase of CI in the control group, and no significant changes in the septic group. Blood volume measurement and administration of a hypertonic solution consisting of glucose alone revealed that this effect on cardiac function was due to the enhanced contractility of the heart, not due to the increased blood volume. In the early post burn group, GIK therapy resulted in a remarkable increase of urine volume (p＜0.01) partially induced by the elevated CI. In the control group and the septic group, however, GIK therapy resulted in a transient increase of urine volume, chiefly attributable to the diuretic effect of the hypertonic solution.
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