Clinical evaluation of glucagon by continuous infusion in the treatment of low cardiac output states

Study of the cardiovascular effects of glucagon in man have shown a positive inotropic and chronotropic effect resulting in an increase in cardiac output.1-3 These effects occur one to 3 minutes after the intravenous injection of 3 to 5 mg. of glucagon and are dissipated in 30 minutes. These effects are similar to those of isoproterenol; however, glucagon has a limited chronotropic effect in man’ and has not caused arrhythmias even in the presence of digitalis.2 In contrast, a recent study of patients with chronic valvufar heart disease concluded that these cardiac effects were variable, not dose-related, and of small magnitude when present.4 In addition to these cardiac effects, glucagon has been shown to increase renal excretion of water and electrolytes.6 Since previous studies are limited to the observation of the effects of a single bolus injection, given to patients who were not in stress situations, it seemed appropriate to study the feasibility and efficacy of a continuous infusion of glucagon over a period of days in the treatment of conditions with low cardiac output or cardiogenic shock. Methods