title: Minimally diluted tepid blood cardioplegia.
abstract: BACKGROUND
  To evaluate the effects of minimally diluted tepid blood cardioplegia, a prospective, randomized study was undertaken.
  
  
  METHODS
  Thirty-seven patients undergoing isolated primary coronary artery bypass grafting were randomized to receive standard 4:1 diluted tepid blood cardioplegia (4:1 group, n = 18) or minimally diluted tepid blood cardioplegia (Mini group, n = 19). Cardioplegic solution was delivered in an intermittent antegrade fashion in both groups. Myocardial oxygen and lactate metabolism, release of the MB isoenzyme of creatine kinase and thiobarbituric acid reactive substances, and cardiac function were measured during and after the operation.
  
  
  RESULTS
  Myocardial oxygen consumption was significantly greater and lactate release was significantly lower in the Mini group than in the 4:1 group during cardioplegia. Minimally diluted blood cardioplegia resulted in more prompt resumption of lactate extraction, lower levels of release of the myocardial-specific isoenzyme of creatine kinase and thiobarbituric acid reactive substances during reperfusion, and better postoperative left ventricular function compared with the standard 4:1 cardioplegia.
  
  
  CONCLUSIONS
  Minimally diluted tepid blood cardioplegia may provide superior myocardial protection than the standard 4:1 dilution technique by optimizing the aerobic environment through an increase in oxygen supply during intermittent cardioplegia.
authors.affiliation: Second Department of Surgery, Kurume University, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Hayashida
authors.forename: T
authors.initials: T
authors.lastname: Isomura
authors.forename: T
authors.initials: T
authors.lastname: Sato
authors.forename: H
authors.initials: H
authors.lastname: Maruyama
authors.forename: T
authors.initials: T
authors.lastname: Higashi
authors.forename: K
authors.initials: K
authors.lastname: Arinaga
authors.forename: S
authors.initials: S
authors.lastname: Aoyagi
mesh_terms: D000328:Adult; D000368:Aged; D001026:Coronary Artery Bypass; D003402:Creatine Kinase / Q000378:metabolism; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006439:Hemodynamics; D006801:Humans; D007527:Isoenzymes; D007773:Lactates / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D010101:Oxygen Consumption; D011446:Prospective Studies
chemical_list: D007527:Isoenzymes; D007773:Lactates; D003402:Creatine Kinase