[The use of ultra-high doses of insulin for the treatment of severe heart failure during cardiosurgical interventions].
The experience is reviewed on the use of superhigh insulin doses 1200 to 3800 U (31.4 +/- 5.3 U/kg) for the treatment of acute heart failure in 17 patients subjected to open heart surgery. Symptoms of heart failure refractory to catecholamines and vasodilators were accompanied by marked hyperglycemia (23.1 +/- 4.3 mmol/l). It was impossible to discontinue assisted circulation. In 82.3% of patients myocardial contractility upon insulin administration improved considerably, which led to discontinuation of assisted circulation with moderate inotropic support. Possible mechanisms ensuring the efficacy of massive insulin therapy in patients with acute heart failure are discussed.
Kozlov
I A
IA
Piliaeva
I E
IE
Zhigareva
E Iu
EIu
Sazontseva
I E
IE
D000293:Adolescent; D000328:Adult; D002303:Cardiac Output, Low / Q000188:drug therapy*; D006348:Cardiac Surgical Procedures; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D007431:Intraoperative Complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
D007328:Insulin
Ispol'zovanie sverkhvysokikh doz insulina dlia lecheniia tiazheloĭ serdechnoĭ nedostatochnosti vo vremia kardiokhirurgicheskikh vmeshatel'stv.