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Hyperinsulinemic Normoglycemia Minimally Improves Myocardial Performance During Cardiac Surgery: A Randomized Trial

Duncan, Andra E

Abstract Details

2014, Master of Sciences, Case Western Reserve University, Clinical Research.
Background: Glucose-insulin-potassium (GIK) solutions, given to improve myocardial performance, are inconsistently effective, perhaps because hyperglycemia negates its beneficial effects. Targeting normoglycemia during GIK infusion, using a hyperinsulinemic normoglycemic clamp (HNC), may enhance GIK effects. Our goal was to examine the benefit of glucose-insulin-potassium while targeting normoglycemia with HNC during cardiac surgery. Methods and Results: Cardiac surgical patients were randomly assigned to HNC versus standard therapy. Primary outcomes included myocardial strain and strain rate, assessed with speckle-tracking echocardiography. Of one-hundred patients, echocardiographic data was adequate in seventy-two (HNC 36, standard 36) for strain and sixty-seven (HNC 33, standard 37) for strain rate analysis. Myocardial strain was not different between groups. Strain rate was improved with HNC (-1.1 ± 0.3 sec-1) compared with standard care ( 1.0 ± 0.3 sec-1, P =0.007). Conclusions: HNC administration during cardiac surgery provided a slight, but not clinically meaningful, improvement in myocardial function.
Douglas Einstadter, MD, MPH (Committee Chair)
Dan Sessler, MD (Committee Member)
Eugene Blackstone, MD (Committee Member)
59 p.

Recommended Citations

Citations

  • Duncan, A. E. (2014). Hyperinsulinemic Normoglycemia Minimally Improves Myocardial Performance During Cardiac Surgery: A Randomized Trial [Master's thesis, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1401799541

    APA Style (7th edition)

  • Duncan, Andra. Hyperinsulinemic Normoglycemia Minimally Improves Myocardial Performance During Cardiac Surgery: A Randomized Trial . 2014. Case Western Reserve University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1401799541.

    MLA Style (8th edition)

  • Duncan, Andra. "Hyperinsulinemic Normoglycemia Minimally Improves Myocardial Performance During Cardiac Surgery: A Randomized Trial ." Master's thesis, Case Western Reserve University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1401799541

    Chicago Manual of Style (17th edition)