Metabolism in ischemic muscles before and after treatment with glucose-insulin-potassium infusion.

Arteriosclerosis, arterial thrombosis and emboli in the lower extremities of man result in metabolic disorders in the muscles due to a deficit between oxygen required and oxygen made available. Furthermore, diminished perfusion pressure results in diminished exchange of substrates and electrolytes across the capillary walls. In the muscle cells there is a depression of glycolytic enzyme function and a stimulation of lipid activity, resulting in accumulation of free fatty acids and acidosis within the cells. In order to increase R.Q. in the muscles in question, infusion of glucose-insulin-potassium were installed via a catheter introduced into the superior vena cava for 3 days. Following this, muscle samples showed significant increase of carbohydrate metabolism as compared to lipid metabolism and nearly normalization of intracellular content of free fatty acids. This was accompanied by improvement of the clinical condition of the patients and loss of pain in the extremities affected.