Metabolic monitoring of postischemic myocardium during intermittent warm-blood cardioplegic administration.
In 12 patients undergoing elective myocardial revascularization with intermittent administration of warm-blood cardioplegic solution for myocardial protection, we analyzed metabolic changes by assay of global ischemia indicators (pH, lactate, glucose, and potassium), which we measured in the coronary sinus and arterial blood during the ischemic and postischemic periods. A typical cumulative ischemic pattern with progressively decreasing pH values and progressively increasing lactate values could not be observed in all patients. It was not the degree of lactate washout, but the lactate concentration at the end of each reperfusion, that correlated significantly with global metabolic recovery time, which suggests the importance of effective reperfusion.
Borowski
Andreas
A
Department of Thoracic & Cardiovascular Surgery, University of Düsseldorf, 40255 Düsseldorf, Germany. Borowski@med.uni-duesseldorf.de
Kurt
Muhammed
M
Calvo
Sanchez
S
Paprotny
Gerrit
G
Godehardt
Erhard
E
Fraessdorf
Jan
J
Ghodsizad
Ali
A
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D002314:Cardioplegic Solutions / Q000627:therapeutic use*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D017558:Elective Surgical Procedures; D004734:Energy Metabolism; D005260:Female; D006324:Heart Arrest, Induced; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D017202:Myocardial Ischemia / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D009206:Myocardium / Q000378:metabolism*; D011188:Potassium / Q000378:metabolism; D011446:Prospective Studies; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
D001786:Blood Glucose; D002314:Cardioplegic Solutions; D019344:Lactic Acid; D011188:Potassium
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