European Journal of Cardio-Thoracic Surgery, Vol 8, 442-446, Copyright © 1994 by European Association for Cardio-thoracic Surgery
Glucose-insulin-potassium (GIK) prevents derangement of myocardial metabolism in brain-dead pigs
B Nilsson, H Berggren, R Ekroth, V Mantovani, F Nilsson, S Svensson and L Wiklund
Department of Cardiothoracic Surgery, Sahlgrenska Hospital, Goteborg, Sweden.
Brain death is associated with neuroendocrine changes resulting in reduced
myocardial glycogen content. The purpose of this study was to investigate
the effects of glucose-insulin-potassium (GIK), on myocardial metabolism in
brain-dead pigs. Sixteen brain-dead pigs were given GIK infusion (n = 8),
or Ringer solution (n = 8). At end-point (7 h post brain death) arterial
concentrations and myocardial arteriovenous (a-v) concentration differences
of glucose, lactate and free fatty acids (FFA) were assessed, and
myocardial biopsy specimens were taken from the right atrium and left
ventricle. Biopsies were also taken from five normal pigs. Myocardial
glycogen content in the GIK group was significantly higher compared to the
control group, but comparable to the non-brain-dead animals. There was a
higher and significant myocardial uptake of glucose and lactate in the GIK
group compared to the controls. Plasma levels of FFA were significantly
lower in the GIK group, and the myocardial uptake of FFA was 5 times higher
in the control group compared to the GIK group. There were no significant
differences in hemodynamic variables among the groups. In conclusion,
intravenous supply of GIK to brain-dead pigs results in increased
myocardial glycogen content and seems to prevent abnormal myocardial
metabolism, which may have clinical implications for the myocardial
protection of donor hearts.
