Articles: glucose-therapeutic-use.
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Randomized Controlled Trial
Myocardial protection by glucose-insulin-potassium in acute coronary syndrome patients undergoing urgent multivessel off-pump coronary artery bypass surgery.
The aim of this randomized and controlled trial was to investigate the effect of a glucose-insulin-potassium (GIK) solution on myocardial protection in acute coronary syndrome (ACS) patients undergoing urgent multivessel off-pump coronary artery bypass (OPCAB) surgery. ⋯ GIK administration in ACS patients undergoing urgent multivessel OPCAB significantly attenuated the degree of ensuing myocardial injury without complications related to glycaemic control. Clinical Trial Registry. URL: http://clinicaltrials.gov/ct2/show/NCT01384656?term=GIK+AND+OPCAB&rank=1. Unique identification number NCT01384656.
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Minerva anestesiologica · Jan 2013
ReviewGlucose and insulin administration while maintaining normoglycemia: the GIN concept.
The benefits of tight glucose control in critically ill and surgical patients remains a subject of debate. While some studies demonstrated a survival benefit associated with intensive insulin therapy, more recent studies have failed to demonstrate this correlation. ⋯ If properly applied, this therapy potentially reduces the morbidity and mortality associated with hyperglycemia and confers the pharmacological advantages of hyperinsulinemia. Further understanding of the underlying molecular mechanisms, as well as the development of a continuous intravenous glucose monitoring device would facilitate the routine clinical use of GIN therapy.
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Hyperkalaemia, an elevated extracellular fluid potassium concentration, is a common electrolyte disorder and is present in 1-10% of hospitalised patients. Elevated serum potassium concentrations are usually asymptomatic but may be associated with electrocardiogram (ECG) changes. Hyperkalaemia occasionally leads to life-threatening cardiac arrhythmias. ⋯ Nebulised β-2 adrenoceptor agonists can augment the effects of intravenous insulin and glucose pending more definitive management of the recurrent hyperkalaemia risk. Additional management steps include stopping further potassium intake and careful review of prescribed drugs that may be adversely affecting potassium homeostasis. Changes to prescribing systems and an agreed institutional protocol for management of hyperkalaemia can improve patient safety for this frequently encountered electrolyte disorder.
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We recently observed a case of propafenone self-poisoning in which the patient was initially unresponsive to conventional therapies such as sodium bicarbonate, dopamine, and norepinephrine but recovered with intravenous glucose-insulin infusion. We raised the hypothesis that insulin may have a cardioprotective effect in acute propafenone toxicity. ⋯ Glucose-insulin infusion delayed the abnormalities in cardiac conduction and improved rat survival after acute propafenone toxicity. These results suggest a cardioprotective effect of glucose-insulin in acute propafenone toxicity.
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Anesteziol Reanimatol · May 2012
Clinical Trial[Modern aspects of diabetic ketoacidosis treatment in children].
The aim of the research - the analysis of the regularities of diabetic ketoacidosis treatment in children and adolescents with type 1 diabetes mellitus, the explanation of the results obtained with the use of biological systems stability theory elements. MATHERIALS AND METHODS: The study included 90 children with type I diabetes mellitus in a state of diabetic ketoacidosis of different severity degree. With newly diagnosed type 1 diabetes mellitus - 56 children, with the "courced" diabetes - 34 children. In the evaluation of patients status was defined glucose, pH, and other indicators of acid-base status, using gas analyzer GEM Premier 3000 ("Instrumental laboratory", USA). ⋯ The offered technique for diabetic ketoacidosis treatment on the basis of the glucose solutions infusion throughout the treatment and "small" doses of insulin values pH and glucose in a safe range, even in patients with high risk of brain edema, which is confirmed by biological systems stability theory.