[Treatment of symptomatic vasospasm with GIK (glucose-insulin-potassium) infusion].
GIK (glucose-insulin-potassium) solution has been administered to myocardial infarction patients as a polarizing therapy, but the effects of GIK administration on vasospasm after subarachnoid hemorrhage have never been reported. We used GIK solution to treat 7 cases of symptomatic vasospasm with congestive heart failure due to hypervolemia-hypertensive treatment. The GIK solution, composed of 200cc of 50% glucose solution, 250cc of water, 40 mEq of KCl, and 20 units of actrapid insulin, was administered continuously through a central venous catheter. The GIK therapy improved congestive heart failure following elevation of cardiac output in 7 cases, and simultaneously stabilized the serum glucose level within the range of 88-175 mg/dl. After GIK administration, remarkable improvement in the consciousness level was achieved in all cases, and cerebral infarction due to vasospasm appeared in only one case in spite of severe subarachnoid hemorrhage. It is thought that GIK therapy will be effective in the treatment of symptomatic vasospasm with congestive heart failure through the normalization of hemodynamics, the improvement of hyperglycemia and protection against cerebral ischemia.
Department of Neurosurgery, Kitakyushu City Yahata Hospital, Japan.
C
C
Horimoto
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Tsutsumi
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M
Tsujimura
D000368:Aged; D004341:Drug Evaluation; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D002546:Ischemic Attack, Transient / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000008:administration & dosage / Q000627:therapeutic use; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000628:therapy
D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D005947:Glucose; D011188:Potassium