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June 30, 1978

Glucose-Insulin-Potassium Solution and Hypoglycemia

Author Affiliations

University of North Carolina Chapel Hill

JAMA. 1978;239(26):2757-2758. doi:10.1001/jama.1978.03280530021004

To the Editor.—  Glucose-insulin-potassium (GIK) solution was originally introduced as a possible means of preservation of the ischemic myocardium.1 In this institution GIK solution has been used preoperatively for 12 hours in adult patients undergoing coronary-artery-bypass graft procedures to protect the ischemic myocardium before and during the institution of cardiopulmonary bypass. In recent months we have begun use of the membrane oxygenator and have used crystaloid pump prime (lactated Ringer's solution to albumin in the ratio 1 liter to 25 g) instead of the partial blood prime that had been used with the bubble oxygenator.When the patient arrived in the operating room, the administration of GIK solution was discontinued. Intravenous fluid administration was continued with 1 liter of 5% dextrose in 0.2 normal saline, followed by lactated Ringer's solution until cardiopulmonary bypass began. We obtained blood glucose levels before starting the bypass and at one-half hour after bypass