Effect of pH shifts induced by oxygenating crystalloid cardioplegic solutions.
Oxygenation of a bicarbonate-containing crystalloid cardioplegic solution alters the partial pressure of both oxygen (O2) and carbon dioxide (CO2). Therefore, oxygenating St. Thomas' Hospital II plus glucose (11 mmol/L) cardioplegic solution with 95% O2 + 5% CO2 induces a pH shift to 7.0 (10 degrees C) as opposed to pH 9.3 with 100% O2. In an isolated working rat heart model, we show that pH 7.0 (10 degrees C) improves mechanical postischemic recovery in the absence or presence of O2. However, in the absence of O2, pH 7.0 appears to inhibit glycolysis and diminish the stability of cellular membranes. The provision of O2 independently improved mechanical recovery and at pH 7.0, improved the preservation of the sarcolemma. Increasing the O2 content by including a perfluorocarbon (FC-43) in the oxygenated St. Thomas' plus glucose cardioplegia is not additionally beneficial. St. Thomas' Hospital plus glucose cardioplegic solution should be oxygenated, but with 95% O2 + 5% CO2 and not 100% O2.
von Oppell
U O
UO
Ischaemic Heart Disease Laboratory, University of Cape Town, South Africa.
King
L M
LM
Du Toit
E F
EF
Owen
P
P
Reichart
B
B
Opie
L H
LH
D000818:Animals; D001639:Bicarbonates; D002122:Calcium Chloride; D002302:Cardiac Output; D002314:Cardioplegic Solutions; D000077324:Crystalloid Solutions; D005947:Glucose; D006019:Glycolysis; D006321:Heart / Q000502:physiology*; D006863:Hydrogen-Ion Concentration; D066298:In Vitro Techniques; D007552:Isotonic Solutions; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D007773:Lactates / Q000378:metabolism; D019344:Lactic Acid; D008274:Magnesium; D008297:Male; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism; D010100:Oxygen; D010101:Oxygen Consumption; D010952:Plasma Substitutes; D011189:Potassium Chloride; D011773:Pyruvates / Q000378:metabolism; D051381:Rats; D011919:Rats, Inbred Strains; D012965:Sodium Chloride; D013318:Stroke Volume
D001639:Bicarbonates; D002314:Cardioplegic Solutions; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D007773:Lactates; D010952:Plasma Substitutes; D011773:Pyruvates; C041711:St. Thomas' Hospital cardioplegic solution; D019344:Lactic Acid; D012965:Sodium Chloride; D011189:Potassium Chloride; D007770:L-Lactate Dehydrogenase; D008274:Magnesium; D005947:Glucose; D002122:Calcium Chloride; D010100:Oxygen