Prather J W, Russell R O, Mantle J A, McDaniel H G, Rackley C E
Am J Cardiol. 1976 Jul;38(1):95-9. doi: 10.1016/0002-9149(76)90068-0.
Eighteen patients treated with glucose-insulin-potassium infusion for anaerobic support of acutely ischemic myocardial tissue were studied to ascertain the metabolic consequences of this therapy, for acute myocardial infarction. Twelve patients with acute myocardial infarction were treated in a conventional manner and served as control subjects. The glucose-insulin-potassium solution was composed of 300 g of glucose, 50 units of regular insulin and 80 mEq of potassium ion per liter, and was infused at a rate of 1.5 ml/kg per hour through the right atrial port of an indwelling Swan-Ganz thermodilution catheter. Serial measurements of serum electrolytes, cardiac and hepatic enzymes, glucose and osmolality were obtained every 4 to 6 hours for 4 days. Twenty-four urinary volume and potassium levels were measured daily. Pulmonary arterial end-diastolic pressure was measured hourly and the cardiac index daily for the duration of the study. Serum potassium increased to 5 mEq/liter during the infusion and to more than 6 mEq/liter after infusion in 28 percent of patients. No recognizable complications or arrhythmias accompanied this transient hyperkalemia. Potassium balance studies revealed a net total body potassium ion gain of 120 MEq during the study. The second most frequent finding was an elevation of serum glucose (mean 175 mg/100 ml); in all instances this was controlled with supplemental administration of insulin. The serum osmolality and fluid balance remained normal in all patients during the study. Serum glutamic oxaloacetic transaminase (SGOT) and fraction 5 of lactic dehydrogenase (LDH) were increased in 34 percent of the patients during the last 12 to 18 hours of the glucose-insulin-potassium infusion. Characterization of these enzymes suggested a hepatic origin for these changes. This study suggests that glucose-insulin-potassium infusion is a relatively safe procedure in which postinfusion hyperkalemia is the most serious potential complication.
对18例接受葡萄糖-胰岛素-钾输注以厌氧支持急性缺血心肌组织的患者进行了研究，以确定该疗法对急性心肌梗死的代谢影响。12例急性心肌梗死患者接受传统治疗并作为对照。葡萄糖-胰岛素-钾溶液每升含300克葡萄糖、50单位正规胰岛素和80毫当量钾离子，通过留置的Swan-Ganz热稀释导管的右心房端口以每小时1.5毫升/千克的速率输注。在4天内每4至6小时进行一次血清电解质、心脏和肝脏酶、葡萄糖和渗透压的系列测量。每天测量24小时尿量和钾水平。在研究期间每小时测量肺动脉舒张末期压力，每天测量心脏指数。28%的患者在输注期间血清钾升至5毫当量/升，输注后升至6毫当量/升以上。这种短暂的高钾血症未伴有可识别的并发症或心律失常。钾平衡研究显示，研究期间全身钾离子净增加120毫当量。第二常见的发现是血清葡萄糖升高（平均175毫克/100毫升）；在所有情况下，这都通过补充胰岛素得到控制。研究期间所有患者的血清渗透压和液体平衡均保持正常。在葡萄糖-胰岛素-钾输注的最后12至18小时内，34%的患者血清谷草转氨酶（SGOT）和乳酸脱氢酶（LDH）的第5组分升高。这些酶的特征表明这些变化起源于肝脏。这项研究表明，葡萄糖-胰岛素-钾输注是一种相对安全的程序，其中输注后高钾血症是最严重的潜在并发症。
