RESUMEN
The incidence of arrhythmias, low output and acute myocardial infarction in the perioperative period was analyzed for 119 patients who underwent aortocoronary bypass surgery. The incidence for three groups of patients was as follows: 44% for 72 patients who did not receive glucose-insulin-potassium (GIK) before operation (no-GIK group), 32% for 25 patients who received preoperative GIK alone before operation (GIK group) and zero in 22 patients who received GIK before operation plus a bolus of 50% glucose (0.5 ml/kg body weight) at the beginning of operation (GIK-G group) (the difference between the GIK-G group and the other two groups is significant; P less than 0.001). Determination of myocardial glycogen content of 63 ventricular biopsies revealed a 2+ to 4+ content in 48% of the no-GIK group, 83% of the GIK group and 100% of the GIK-G group (P less than 0.05). The incidence of complications in patients with myocardial glycogen content of 2+ to 4+ was significantly lower (P less than 0.005) than in those with myocardial glycogen content of 1+. Experimentally, myocardial tolerance to ischemic injury parallels myocardial glycogen content. Our preliminary observation that prior administration of GIK-G increases myocardial glycogen content with a concomitant reduction in complications is consistent with these experimental observations.