title: Preservation of myocardial function and biochemistry after blood and oxygenated crystalloid cardioplegia during cardiac arrest.
abstract: We compared the ability of blood cardioplegia and oxygenated crystalloid cardioplegic solutions to maintain regional left ventricle contractility and adenosine triphosphate levels after cardiopulmonary bypass. Ten baboons were subjected to 90-minute cardiopulmonary bypass conducted at 28 degrees C. Hemodynamic measurements were made before and after the bypass procedure, and biopsies for high-energy phosphate determinations were performed at different time intervals during and after bypass. The results showed improved maintenance of myocardial contractility (measured with the regional end-systolic pressure-length relationship) with the oxygenated crystalloid solution. Expressed as a percentage of values before bypass, contractility after bypass averaged 81.69% +/- 4.81% and 80.47% +/- 10.05%, respectively, after 10 and 20 minutes using the oxygenated crystalloid cardioplegia. For blood cardioplegia, the corresponding values were 71.9% +/- 8.73% and 64.99% +/- 8.60% (mean +/- standard error of the mean). The 10- and 20-minute postbypass values between the two groups differed significantly (t test, Welch modification: p = 0.0464 and p = 0.0342). Myocardial adenosine triphosphate level was higher immediately after induction of cardiac arrest when blood cardioplegia was used (blood cardioplegia, 6.82 mol.g wet wt-1; crystalloid cardioplegia, 4.95 mol.g wet wt-1; p = 0.0314), but values subsequently equalized.
authors.affiliation: Department of Anesthesiology, University of Stellenbosch Medical School, Tygerberg, South Africa.
authors.forename: A
authors.initials: A
authors.lastname: Coetzee
authors.forename: G
authors.initials: G
authors.lastname: Roussouw
authors.forename: P
authors.initials: P
authors.lastname: Fourie
authors.forename: A
authors.initials: A
authors.lastname: Lochner
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001769:Blood; D002314:Cardioplegic Solutions; D002315:Cardiopulmonary Bypass; D006324:Heart Arrest, Induced / Q000379:methods*; D009200:Myocardial Contraction / Q000502:physiology; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism; D010215:Papio; D011188:Potassium; D017680:Potassium Compounds; D013997:Time Factors
chemical_list: D002314:Cardioplegic Solutions; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D000255:Adenosine Triphosphate; D011188:Potassium