Regional blood flow and metabolism in canine endotoxin shock before, during, and after infusion of glucose-insulin-potassium (GIK).

Glucose-insulin-potassium infused (GIK) during endotoxin shock causes increased cardiac output (CO) accompanied by decreased systemic vascular resistance. We have studied the effects of GIK on the distribution of cardiac output with radioactive microspheres to see if this decrease in resistance is equally distributed over all organs. GIK resulted in increased CO and increased flow to heart, splanchnic bed, kidneys, adrenals, and skeletal muscle, but fractional flow to these organs did not change. Thirty minutes after the GIK infusion, CO and organ flow had fallen again and differences between the endotoxin and control groups were no longer significant. GIK thus increases CO during endotoxin shock but does not influence its distribution. Systemic oxygen transport increased after GIK, but oxygen extraction decreased. Myocardial and splanchnic oxygen consumption did not change significantly. Oxygen extraction also diminished in these areas after GIK. GIK did not influence serum lactate: In both groups lactate increased significantly.