Glucose-insulin-potassium infusion in acute myocardial infarction

A solution of 300 gm of glucose, 50 units of regular insulin, and 80 mEq of potassium chloride in 1,000 ml of sterile water infused at a rate of 1.5 ml/kg of body weight per hour can alter the availability of glucose and free fatty acids to the myocardium. Clinical studies of patients receiving this infusion less than 15 hours after the onset of symptoms of acute myocardial infarction suggest a reduction in mortality, an improvement in left ventricular mechanical performance, and a reduction in cardiac irritability as beneficial effects. Swan-Ganz catheterization for hemodynamic, electrophysiologic, and metabolic monitoring is recommended. Diabetics who require insulin and patients with impaired renal function are not candidates for the infusion. Further clinical studies are required before conclusions can be reached regarding the efficacy of glucose-insulin-potassium infusion in attempts to salvage damaged myocardium.