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(Chest. 2006;129:800-804.)
© 2006 American College of Chest Physicians

Glucose-Insulin and Potassium Infusions in Septic Shock*

Shahir S. Hamdulay, BSc, MRCP; Ali Al- Khafaji, MD, MPH, FCCP and Hugh Montgomery, MD, MRCP

* From the Department of Intensive Care Medicine (Drs. Hamdulay and Montgomery), University College London Foundation Hospitals, The Middlesex Hospital, London, UK; and Department of Intensive Care Medicine (Dr. Al-Khafaji), University of Pittsburgh School of Medicine, Pittsburgh, PA.

Correspondence to: Shahir Hamdulay, BSc, MRCP, Department of Medicine, Hammersmith Hospital, Du Cane Rd, London W12 0HS, UK; e-mail: sh_hamdu{at}hotmail.com

Glucose-insulin and potassium (GIK) infusions are beneficial in treating ischemic myocardial depression. Myocardial depression is also an important feature in septic shock. We describe two cases of pressor-resistant hypodynamic septic shock that responded to high-dose GIK infusions. In each case, hemodynamic profiles improved sufficiently to allow withdrawal of vasopressor agents. Further assessment of GIK in patients with hypodynamic septic shock is necessary to confirm efficacy and prognostic significance.

Key Words: antiinflammatory • glucose-insulin and potassium • insulin • myocardium • sepsis • shock




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M. Y. Rady, S. S. Hamdulay, H. Montgomery, A. Al-Khafaji, J. M. Marchant, A. B. Chang, and B. K. Rubin
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