Using glucose-insulin-potassium (GIK) in cardiological patients: history and present

In 1962, in the American Journal of Cardiology, a group of authors led by D. Sodi-Pаllares reported that the use of a mixture of glucose, insulin and potassium (GIK) in patients with myocardial ischemia was accompanied by positive changes in the electrocardiogram. Further clinical observations confirmed the presence of some benefit from the use of this metabolic cocktail in patients with acute myocardial infarction (MI). It was believed that perfusion of anoxic heart cells with solutions with an increased content of glucose, insulin and potassium enhances myocardial contractile function. In experimental and early clinical studies, it was shown that intravenous administration of the GIK mixture contributes to a decrease in the size of myocardial infarction and a decrease in hospital mortality. Since then, many large randomized trials have been published that have studied the role of GIK in the treatment of MI, but their results have not been as optimistic and unanimous. The article presents the pathogenetic mechanisms of action of GIK and analyzes the results of studies on the use of GIK in cardiological and cardiac surgical patients. The indications and features of the use of this mixture in clinical practice are discussed.Conclusions. Thus, clinical recommendations for the use of GIK in cardiac patients remain somewhat controversial. Today, it is possible to recommend the administration of GIK solutions in cardiac patients in the following clinical situations: 1) Perioperative period during cardiac surgical operations; 2) Arrhythmias caused by hypokalemia, including intoxication with cardiac glycosides; 3) Severe hypokalemia (serum potassium concentration less than 2.5 mmol/l); 4) Acute myocardial infarction in patients with type 2 diabetes.It should also be noted that the dosage regimen of GIK for a particular patient should be established individually, with careful monitoring of the electrocardiogram and serum potassium levelKey words: glucose-insulin-potassium mixture (GIK), cardiology, acute coronary syndrome, myocardial infarction, cardiac surgery.