The myocardial protective effects of a moderate-potassium adenosine-lidocaine cardioplegia in pediatric cardiac surgery.
OBJECTIVE
We sought to evaluate a moderate-potassium cardioplegic solution using adenosine and lidocaine as the arresting and protecting cardioprotective combination in pediatric cardiac surgery.


METHODS
One hundred thirty-four patients with congenital heart disease were randomly allocated to one of 3 groups according to the cardioplegia formula used: the high-potassium (HP) group (K(+), 20 mmol/L), 46 patients; the high-potassium adenosine-lidocaine (HPAL) group (K(+), 20 mmol/L; adenosine, 0.7 mmol/L; and lidocaine, 0.7 mmol/L), 44 patients; and the moderate-potassium adenosine-lidocaine (MPAL) group (K(+), 10 mmol/L; adenosine, 0.7 mmol/L; and lidocaine, 0.7 mmol/L), 44 patients. Hemodynamic data during the operation and postoperative data were recorded. Serum cardiac troponin I concentrations were examined at the time points of before cardiopulmonary bypass and 1, 3, 6, 12, and 24 hours after aortic crossclamp removal.


RESULTS
At the end of cardiopulmonary bypass and modified ultrafiltration, the systolic and pulse pressures of the MPAL group were significantly increased compared with the respective values of the HP group. At the time points of 1 to 12 hours after reperfusion, the levels of serum cardiac troponin I were significantly decreased in the MPAL group compared with those in the HP and HPAL groups.


CONCLUSIONS
The MPAL cardioplegia formula was associated with better myocardial protective effects.
Jin
Zhen-Xiao
ZX
Institute of Cardiovascular Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
Zhang
Sheng-Li
SL
Wang
Xi-Ming
XM
Bi
Sheng-Hui
SH
Xin
Mei
M
Zhou
Jing-Jun
JJ
Cui
Qin
Q
Duan
Wei-Xun
WX
Wang
Hong-Bing
HB
Yi
Ding-Hua
DH
D000241:Adenosine / Q000008:administration & dosage / Q000494:pharmacology; D006348:Cardiac Surgical Procedures; D002314:Cardioplegic Solutions / Q000008:administration & dosage / Q000494:pharmacology*; D002315:Cardiopulmonary Bypass; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000494:pharmacology*; D002675:Child, Preschool; D005260:Female; D006321:Heart / Q000187:drug effects*; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology; D008297:Male; D009206:Myocardium; D011188:Potassium / Q000008:administration & dosage / Q000494:pharmacology
D002314:Cardioplegic Solutions; D002316:Cardiotonic Agents; D008012:Lidocaine; D000241:Adenosine; D011188:Potassium