Solución de glucosa-insulina-potasio (GIK): efectos cardioprotectores de la insulina / Glucose-insulin-potassium (GIK) solution: cardioprotective effects of insulin
Arch. cardiol. Méx
; 76(supl.4): S144-S151, oct.-dic. 2006.
Article
in Es
| LILACS
| ID: lil-568125
Responsible library:
BR1.1
ABSTRACT
In the Anesthesiology Department of the Instituto Nacional de Cardiología The medical staff uses the glucose insulin potassium i.v. for myocardial protection. The energy is dereived from lipidic beta oxidation, glucose breakdown and amino acid catabolism in mitochondria. In myocardial ischemia, from de aortic cross clamping, the metabolic myocardial substrates diminished as well as the energy produced by adenosine (ATP). During myocardial ischemia, an increase in long chain lipids emhances mitochondrial permeability, promotes depletion of citochrome C and lost of the capability of transmembrane regulation. In the hipoperfused myocardium, by coronary vasoconstriction, short chain fatty acids oxidation predominates, if fatty metabolism during reperfusion is elevated. More of them will enter [IBM1] the Krebs cycle and, as a consequence, less energy will be produced. The glucose-insulin-potassium solution provides the glucose needed by the myocardium in reperfusion conditions and protects the cellular membrane's integrity as well as pumps and ionic channels, it allows maintaining the action potential probably because ATP-depended channels block and prevent potassium loss, it reduces the cytosol calcium overload and prevent cardiac arrhythmias, preserves the sodium ATPasa pump avoiding the rise in cytosolic sodium; glucose prevents the production of free oxygen radicals. Fatty acids, during ischemia, are responsible for the metabolism and elevation of enzymes, such as acilcarnitine and acylcoenzime-A, which promote intracellular calcium overload and arrhythmias. The insulin has anti-inflammatory effects and anti-apoptoic effects. When blood glucose is controlled during the perioperative period the mortality is reduced.
Full text:
1
Index:
LILACS
Main subject:
Cardioplegic Solutions
/
Diabetes Complications
/
Cardiac Surgical Procedures
/
Hypoglycemic Agents
/
Insulin
Type of study:
Etiology_studies
/
Guideline
/
Risk_factors_studies
Limits:
Adult
/
Child
/
Humans
/
Newborn
Language:
Es
Journal:
Arch. cardiol. Méx
Journal subject:
CARDIOLOGIA
Year:
2006
Type:
Article