Cardiac arrest: a late complication of glucose-insulin-potassium (GIK) therapy.

Rebound hyperkalaemia 4 hours after discontinuation of a glucose-insulin-potassium infusion inhibited an already compromised conduction system leading to ventricular standstill in a 41 year old man after re-do aortic valve surgery. Resuscitation was successful and allowed him to return from Australia to his home on Christmas Island. Glucose-insulin-potassium (GIK) infusions to reduce myocardial hypo-/re-perfusion injury after myocardial infarction, during coronary artery surgery and cardiopulmonary bypass are becoming more popular. There may also be a role for GIK in the treatment of refractory dysrhythmias and for myocardial protection in the brain-dead patient. However, these infusions are not without hazard and this report of rebound hyperkalaemia and cardiac arrest is unlikely to remain isolated.