[Clinical evaluation of myocardial protection by oxygenated crystalloid cardioplegic solutions with DBcAMP].
Possible enhancement of myocardial protection by adding DBcAMP and oxygenation of a crystalloid cardioplegic solution (CCS) was evaluated in a three group study. The patients having coronary bypass operation or valvular operation were divided into three groups, each consisting of 15 patients, and differing only in the type of CCS employed. Group I was protected by nonoxygenated CCS (PO2 190 mmHg, PCO2, 32 mmHg, pH 7.78, K 30 mmEq/L), Group II by adding DBcAMP to nonoxygenated CCS and Group III by adding DBcAMP to oxygenated CCS (PO2 790 mmHg, PCO2 26 mmHg, pH 7.87). Group III had significantly improved CI and double product (p less than 0.05) compared with Group II. However, CPK, CPK-MB, and myoglobin in the serum were similar in each group. Lactate and pyruvate ratio (L/P) in the coronary sinus bloods were improved to lower value after the pump than before the pump only in Group III. Base excess in the coronary sinus held on alkalosis after aortic declamp only in Group III. The refunction time was significantly shortest with Group III than with other groups (p less than 0.01, 0.05) and Group II was significantly shorter than Group I (p less than 0.05). It is concluded that oxygenation and adding DBcAMP to CCS are effectual for the myocardial metabolism and protect the myocardial damage during cardiac arrest.
Ishikura
Y
Y
Department of Thoracic Cardiovascular Surgery, School of Medicine, University of Occupational & Environmental Health, Kitakyushu, Japan.
Odagiri
S
S
Shimazu
A
A
Hirao
D
D
Watanabe
H
H
Hatooka
S
S
Hamada
M
M
D000328:Adult; D000368:Aged; D003994:Bucladesine / Q000627:therapeutic use*; D002314:Cardioplegic Solutions; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D007527:Isoenzymes; D007773:Lactates / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D010100:Oxygen / Q000627:therapeutic use*; D011188:Potassium / Q000627:therapeutic use; D017680:Potassium Compounds; D011773:Pyruvates / Q000378:metabolism
D002314:Cardioplegic Solutions; D007527:Isoenzymes; D007773:Lactates; D017680:Potassium Compounds; D011773:Pyruvates; C018369:potassium cardioplegic solution; D003994:Bucladesine; D003402:Creatine Kinase; D011188:Potassium; D010100:Oxygen