TEPID ANTEGRADE AND RETROGRADE CARDIOPLEGIA

被引:52
作者
HAYASHIDA, N
WEISEL, RD
SHIRAI, T
IKONOMIDIS, JS
IVANOV, J
CARSON, SM
MOHABEER, MK
TUMIATI, LC
MICKLE, DAG
机构
[1] TORONTO HOSP,DEPT CLIN BIOCHEM,DIV CARDIOVASC SURG,TORONTO,ON M5G 2C4,CANADA
[2] TORONTO HOSP,CTR CARDIOVASC RES,TORONTO,ON M5T 2S8,CANADA
[3] UNIV TORONTO,TORONTO,ON,CANADA
基金
英国医学研究理事会;
关键词
D O I
10.1016/0003-4975(94)01056-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To determine the optimal temperature for the combination of antegrade and retrograde cardioplegia, 42 patients undergoing coronary artery bypass grafting were randomized to receive cold (9 degrees C; n = 14), tepid (29 degrees C; n 14), or warm (37 degrees C; n = 14) blood cardioplegia delivered continuously retrograde and intermittently antegrade. Myocardial oxygen utilization, lactate and acid metabolism, and coronary vascular resistance were measured during the operation and cardiac function was assessed postoperatively. Myocardial oxygen consumption, lactate release and acid release were greatest with warm, intermediate with tepid, and least with cold cardioplegia (p = 0.0001). However, washout of lactate and acid at the time of cross-clamp release was reduced (p = 0.022) with tepid or cold compared with warm cardioplegia. Early postoperative left ventricular function was best preserved (p 0.01) after tepid than after cold or warm combination cardioplegia. These results suggest that tepid combination cardioplegia reduced metabolic demands but permitted immediate recovery of cardiac function. This technique may provide better myocardial protection than cold or warm combination cardioplegia.
引用
收藏
页码:723 / 729
页数:7
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