Reinfusion potassium blood cardioplegia versus cold blood reinfusion alone in elective revascularization.
The purpose of this study was to determine if the addition of potassium to reinfusion cold blood cardioplegia (CBC) offers an advantage over cold blood alone. Forty patients matched for age, left ventricular function, extent of coronary disease and number of vessels bypassed were prospectively randomized. Each patient received an initial dose of CBC (10 cc/kg) with potassium. Group I patients (n = 23) received subsequent infusions of CBC (5 cc/kg) containing potassium while Group II patients (n = 17) received cold blood only. The cross-clamp time, mean infusate volume and temperature were not significantly different in the two groups. Following reperfusion, the cardiac index and the CPK isoenzyme release at 0.5, 1, 8, and 12 h after cross-clamp release were not significantly different between the groups. The postoperative appearance of new Q-waves, inotropic agent requirement, and reversal of the lactate dehydrogenase (LDH) isoenzyme ratio were also not significantly different in the two groups. The study demonstrated that following initial arrest with potassium, cold blood is equally as effective as potassium blood cardioplegia in protecting the ischemic myocardium.
Peigh
P
P
Division of Cardiothoracic Surgery, St. Louis University Medical Center, MO 63110-0250.
Fiore
A
A
Naunheim
K
K
Kaiser
G
G
Pennington
D G
DG
McBride
L
L
Willman
V
V
Barner
H
H
D000368:Aged; D000704:Analysis of Variance; D001769:Blood; D002314:Cardioplegic Solutions / Q000494:pharmacology; D003080:Cold Temperature; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006947:Hyperkalemia; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D009204:Myocardial Revascularization / Q000379:methods*; D017680:Potassium Compounds / Q000494:pharmacology; D011336:Probability; D011446:Prospective Studies
D002314:Cardioplegic Solutions; D007527:Isoenzymes; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D003402:Creatine Kinase