title: The myocardial protective effects of a moderate-potassium adenosine-lidocaine cardioplegia in pediatric cardiac surgery.
abstract: 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.
authors.affiliation: Institute of Cardiovascular Surgery, Xijing Hospital, the Fourth Military Medical University, Xi'an, China.
authors.forename: Zhen-Xiao
authors.initials: ZX
authors.lastname: Jin
authors.forename: Sheng-Li
authors.initials: SL
authors.lastname: Zhang
authors.forename: Xi-Ming
authors.initials: XM
authors.lastname: Wang
authors.forename: Sheng-Hui
authors.initials: SH
authors.lastname: Bi
authors.forename: Mei
authors.initials: M
authors.lastname: Xin
authors.forename: Jing-Jun
authors.initials: JJ
authors.lastname: Zhou
authors.forename: Qin
authors.initials: Q
authors.lastname: Cui
authors.forename: Wei-Xun
authors.initials: WX
authors.lastname: Duan
authors.forename: Hong-Bing
authors.initials: HB
authors.lastname: Wang
authors.forename: Ding-Hua
authors.initials: DH
authors.lastname: Yi
mesh_terms: 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
chemical_list: D002314:Cardioplegic Solutions; D002316:Cardiotonic Agents; D008012:Lidocaine; D000241:Adenosine; D011188:Potassium