Peer-reviewed veterinary case report
Insulin and glucose infusion reverses sudden heart collapse
By Kim, Mi-Hyun et al.·Published in Canadian journal of anaesthesia = Journal canadien d'anesthesie·2013·Department of Anesthesiology & Pain Medicine, South Korea·View original on PubMed →
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Original publication title: Insulin/glucose infusion successfully resuscitates bupivacaine-induced sudden-onset circulatory collapse in dogs.
- Species:
- dog
Plain-English summary
A group of dogs experienced sudden heart failure after receiving a rapid injection of bupivacaine, a medication that can be toxic to the heart. In an emergency situation, six dogs were treated with insulin while another six received a saline solution. The dogs that received insulin were successfully resuscitated within about 15 minutes, while none of the dogs given saline recovered. This study shows that insulin can be an effective treatment for heart problems caused by bupivacaine in dogs.
People also search for: dog heart failure treatment · bupivacaine toxicity in dogs · insulin for dog circulatory collapse
Abstract
PURPOSE: In previous studies, insulin reversed the cardiac toxicity gradually induced by a continuous infusion of bupivacaine. In this randomized controlled study, we intended to simulate a more relevant clinical situation by injecting bupivacaine rapidly as a bolus to induce sudden-onset circulatory collapse in dogs. We then evaluated the insulin effect. METHODS: Bupivacaine (10 mg.kg(-1) iv) was rapidly administered intravenously to 12 dogs. At the onset of circulatory collapse (defined as a mean arterial pressure [MAP] of 30 mmHg), external chest compression was initiated. Insulin (2 U.kg(-1) iv) was given to the insulin-glucose (IG) group (n = 6) and the same volume of 0.9% saline was given to the control (C) group (n = 6). The primary outcome was successful resuscitation defined as both MAP ≥ 60 mmHg and sinus rhythm on an electrocardiogram that lasted ≥ 60 sec. Hemodynamic and blood variables were measured, including cardiac output and electrocardiogram intervals. RESULTS: All IG dogs were successfully resuscitated within 15 (3) min, whereas none of the control dogs were resuscitated (P = 0.002). After circulatory collapse, the average MAP was higher in group IG than in group C (P = 0.006). CONCLUSION: Insulin effectively reversed the sudden-onset circulatory collapse in dogs caused by an intravenous bolus injection of bupivacaine.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/23408227/