Tesoro Rosa, Hagerman Andres, Molliqaj Granit, Ellenberger Christoph, Licker Marc
Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland.
Neuroscience, Neurosurgical Unit, Geneva University Hospitals, Geneva, Switzerland.
Saudi J Anaesth. 2022 Jul-Sep;16(3):364-367. doi: 10.4103/sja.sja_195_22. Epub 2022 Jun 20.
The administration of glucose-insulin-potassium (GIK) has demonstrated cardioprotective effects in cardiac surgery. A 58-year-old male with severe disabling back pain due to posterolateral lumbar pseudarthrosis was scheduled for spine surgery. He previously experienced two episodes of acute coronary syndrome that required percutaneous coronary interventions (PCIs). Coronary angiogram showed intrastent occlusions and multiple coronary lesions that were not suitable for percutaneous or surgical revascularization. During pharmacological stress imaging, myocardial ischemia developed in 19% of the ventricular mass and was reduced to 7% when GIK was administered. After anesthesia induction, the GIK solution was also infused and surgery was uneventful, with no signs of postoperative myocardial injury. Four days later, the patient was successfully discharged to a rehabilitation center. This is the first clinical report of GIK pretreatment during non-cardiac surgery in a patient with ischemic heart disease (IHD).
葡萄糖 - 胰岛素 - 钾（GIK）给药已在心脏手术中显示出心脏保护作用。一名58岁男性因后外侧腰椎假关节形成导致严重的致残性背痛，计划进行脊柱手术。他此前曾经历过两次急性冠状动脉综合征发作，需要进行经皮冠状动脉介入治疗（PCI）。冠状动脉造影显示支架内闭塞和多处冠状动脉病变，不适合进行经皮或外科血管重建。在药物负荷成像期间，19%的心室质量出现心肌缺血，给予GIK后缺血减少至7%。麻醉诱导后，也输注了GIK溶液，手术过程顺利，无术后心肌损伤迹象。四天后，患者成功出院前往康复中心。这是缺血性心脏病（IHD）患者非心脏手术期间进行GIK预处理的首例临床报告。
