Preservation of myocardial function and biochemistry after blood and oxygenated crystalloid cardioplegia during cardiac arrest.
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.
Coetzee
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A
Department of Anesthesiology, University of Stellenbosch Medical School, Tygerberg, South Africa.
Roussouw
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G
Fourie
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P
Lochner
A
A
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
D002314:Cardioplegic Solutions; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D000255:Adenosine Triphosphate; D011188:Potassium