GIK back? Glucose-insulin-potassium mix shows promise in cardiac surgery Domenico Pagano and his buddies in Birmingham UK have published this excellent study studying the effects of GIK in patients with left ventricular hypertrophy undergoing aortic valve replacement. A randomized surgical trial always merits respect and praise because of the great logistic difficulty associated with organising surgical trials. Low cardiac output and need of inotropes are a bit soft as outcomes - although this is tempered by the fact that the study was supposed to be double blind.Load independent measures using conductance catheter or fractional shortening measurements using echo may have been useful. As is pointed out at the end of the study, whether all this matters, as far as short and long term clinical outcomes are concerned, will need a larger probably multicentre study - now there's a logistic challenge!
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