insulin + cardioplegia

Insulin-enhanced cardioplegia refers to the clinical practice of adding insulin to cardioplegic solutions used during cardiac surgery to induce elective cardiac arrest and provide myocardial protection. The addition of insulin is intended to optimize myocardial metabolism during the period of global ischemia and subsequent reperfusion. By stimulating glucose uptake and promoting the glycolytic pathway, insulin helps maintain high-energy phosphate stores (ATP) and may reduce the incidence of low cardiac output syndrome and arrhythmias following cardiopulmonary bypass. Insulin acts primarily via the insulin receptor to facilitate GLUT4 translocation and activate survival signaling pathways, such as the PI3K/Akt pathway, which mitigate apoptosis and oxidative stress associated with ischemia-reperfusion injury. The cardioplegic component, typically containing high concentrations of potassium, works by depolarizing the myocardial cell membrane to achieve rapid diastolic arrest, thereby minimizing myocardial oxygen consumption.

Other names

insulin-enhanced cardioplegiainsulin-supplemented cardioplegic solutionGIK cardioplegia