Effects of dobutamine versus insulin on cardiac performance, myocardial oxygen demand, and total body metabolism after coronary artery bypass grafting

Hiesmayr, Michael; Haider, W.; Grubhofer, G.; Heilinger, D.; Keznickl, F.P.; Rajek, Angela; Coraim, F.; Semsroth, M.

doi:10.1016/s1053-0770(05)80225-3

Cited by 12 publications

(10 citation statements)

References 35 publications

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“…9 Whole body oxygen consumption increased with dobutamine while it remained unchanged in GIK infusion. 9 GIK infusion resulted in a lower systemic vascular resistance resulting in a decreased afterload. 8,10 Investigations in normal volunteers are sparse.…”

Section: High-dose Insulin and Enhancement Of LV Functionmentioning

confidence: 93%

“…1 In patients undergoing cardiac surgery, GIK infusion resulted in higher postoperative cardiac indices compared with patients receiving standard treatment. 6,[8][9][10] Cardiac index and LV stroke work index improved both during dobutamine and GIK, but the rate-pressure product and the tension-time index only increased in the dobutamine group. 9 Whole body oxygen consumption increased with dobutamine while it remained unchanged in GIK infusion.…”

Section: High-dose Insulin and Enhancement Of LV Functionmentioning

confidence: 99%

“…6,[8][9][10] Cardiac index and LV stroke work index improved both during dobutamine and GIK, but the rate-pressure product and the tension-time index only increased in the dobutamine group. 9 Whole body oxygen consumption increased with dobutamine while it remained unchanged in GIK infusion. 9 GIK infusion resulted in a lower systemic vascular resistance resulting in a decreased afterload.…”

Section: High-dose Insulin and Enhancement Of LV Functionmentioning

confidence: 99%

“…Most of these studies were performed in animal models [1][2][3][4][5] but also in patients undergoing cardiac surgery. [6][7][8][9][10] Dobutamine enhances overall myocardial performance and contraction, and high-dose insulin (HDI) infusion improves left ventricular systolic function in patients with left ventricular impairment due to ischaemic coronary disease. [11][12][13][14][15] However, the effect of high-dose insulin infusion is less clear in normal subjects; one study with no effects on myocardial function in normal, healthy subjects has been published.…”

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confidence: 99%

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Effects of high-dose insulin infusion on left ventricular function in normal subjects

Klein

Campen²,

Sieswerda³

et al. 2010

NHJL

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Background. Only a few studies have reported on the effect of high-dose insulin (HDI) infusion on cardiac function in healthy volunteers. Methods. We studied ten healthy volunteers with low-dose dobutamine (LDD, 10 mug/kg/min) echo-cardio-graphy and HDI echocardiography (insulin administration for one hour) by volume and Doppler analysis. Results. During LDD, cardiac output increased from 5.7+/-1.3 l/min to 9.0+/-2.1 l/min (p<0.001) and during HDI from 5.5+/-1.2 l/min to 6.2+/-1.1 l/min (p=0.048). Increase was not only due to increase in frequency, which was only present in the LDD study, but also due to increase in stroke volume (from 82+/-15 ml to 110+/-23 ml, p<0.001 during LDD and from 82+/-16 ml to 93+/-24 ml, p=0.014 during HDI). The increase in stroke volume was the result of a decrease in end-systolic volume with an unchanged end-diastolic volume. Conclusion. High-dose insulin infusion results in increased cardiac output by improving systolic myocardial function. (Neth Heart J 2010;18:183-9.).

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Section: High-dose Insulin and Enhancement Of LV Functionmentioning

confidence: 93%

Section: High-dose Insulin and Enhancement Of LV Functionmentioning

confidence: 99%

Section: High-dose Insulin and Enhancement Of LV Functionmentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of high-dose insulin infusion on left ventricular function in normal subjects

Klein

Campen²,

Sieswerda³

et al. 2010

NHJL

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“…36 Whole-body oxygen consumption was reduced during GIK infusion. 36 Studies by others suggested less need for inotropic support and higher cardiac index during GIK infusion and faster weaning from intraaortic balloon pumping after surgery. 37,38 A reduction in mortality was reached in refractory heart failure patients.…”

Section: Effects Of Insulin Administration In Patients With Left Ventmentioning

confidence: 98%

The effect of insulin on the heart

Klein

Visser²

2010

NHJL

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Positive inotropic effects of insulin were described early after the isolation of insulin from the pancreas but data on the effect of insulin on the heart are conflicting. Systemic insulin administration results in a reduction in circulating free fatty acids and an improvement in myocardial glucose uptake, which causes an efficiency improvement in the myocardial cell. There is strong evidence that insulin administration results in functional improvement in dysfunctional myocardium. (Neth Heart J 2010;18:197-201.).

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Management of Cardiovascular Dysfunction after Cardiac Surgery

Metzler¹

2001

Critical Care Cardiology in the Perioperative Period

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Effects of dobutamine versus insulin on cardiac performance, myocardial oxygen demand, and total body metabolism after coronary artery bypass grafting

Cited by 12 publications

References 35 publications

Effects of high-dose insulin infusion on left ventricular function in normal subjects

Effects of high-dose insulin infusion on left ventricular function in normal subjects

The effect of insulin on the heart

Management of Cardiovascular Dysfunction after Cardiac Surgery

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