Metabolic and Hemodynamic Effects of High-Dose Insulin Treatment in Aortic Valve and Coronary Surgery Juha K. Koskenkari, MD, Päivi K. Kaukoranta, MD,

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Metabolic and Hemodynamic Effects of High-Dose Insulin Treatment in Aortic Valve and Coronary Surgery Juha K. Koskenkari, MD, Päivi K. Kaukoranta, MD, PhD, Kai T. Kiviluoma, MD, PhD, M.J. Pekka Raatikainen, MD, PhD, Pasi P. Ohtonen, MS, Tero I. Ala-Kokko, MD, PhD The Annals of Thoracic Surgery Volume 80, Issue 2, Pages 511-517 (August 2005) DOI: 10.1016/j.athoracsur.2005.03.024 Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (a) Postoperative blood glucose levels (glucose-insulin-potassium [Gik], circles, n = 20; control, squares, n = 20). Blood glucose levels were lower (p < 0.001) and better maintained within the targeted range in the Gik group than in the control group. (b) Postoperative blood lactate levels (Gik, n = 20, circles; control, boxes, n = 20). The control group had higher blood lactate levels compared with the Gik group (p = 0.016), and the lactate levels normalized faster in the Gik group (p = 0.046). Values are presented as a median and 25th and 75th percentiles. (ICU = intensive care unit.) The Annals of Thoracic Surgery 2005 80, 511-517DOI: (10.1016/j.athoracsur.2005.03.024) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (a) Perioperative cardiac indices (glucose-insulin-potassium [Gik], circles, n = 20; control, squares, n = 20). Cardiac indices were higher in the Gik group than in the control group after perfusion (p = 0.053) and after 8 hours stay in the intensive care unit (ICU [p = 0.062]). Values are presented as median and 25th and 75th percentiles. (b) Perioperative systemic vascular resistance indices (Gik, circles, n = 20, control, squares, n = 20). There were no significant differences between the groups with regard to these variables. Values are presented as median and 25th and 75th percentiles. (CI = cardiac index; ICU 0h = after admission to intensive care unit; ICU 4h = after 4 hours intensive care unit stay; ICU 8h = after 8 hours intensive care unit stay; 1st pod. = first postoperative morning; SVRI = systemic vascular resistance index.) The Annals of Thoracic Surgery 2005 80, 511-517DOI: (10.1016/j.athoracsur.2005.03.024) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Postoperative plasma potassium levels (glucose-insulin-potassium [GIK], circles, n = 20; control, squares, n = 20). Plasma potassium levels were lower in the GIK group than in the control group after the admission into the intensive care unit (p < 0.001). Values are presented as median and 25th and 75th percentiles. (ICU = intensive care unit.) The Annals of Thoracic Surgery 2005 80, 511-517DOI: (10.1016/j.athoracsur.2005.03.024) Copyright © 2005 The Society of Thoracic Surgeons Terms and Conditions