title: Our experience with two cardioplegic solutions: dextrose versus non-dextrose in adult cardiac surgery.
abstract: Intraoperative hyperglycemia has been observed to be associated with increased morbidity and mortality after cardiac surgery. Dextrose cardioplegia is used for its cardioprotective effects but may lead to intraoperative hyperglycemia and more postoperative complications. This was a retrospective observational study. Patient records (n = 2301) were accessed from a large database at a tertiary care facility. The two groups (dextrose vs. nondextrose) were then matched using preoperative variables of age, sex, body mass index, wound exposure time, preoperative HbA1c levels, renal failure, hypertension, and prior cerebrovascular disease. The following outcomes were recorded: 30-day mortality, sternal wound infection, stroke, and highest glucose level on cardiopulmonary bypass. The dextrose cardioplegia group showed statistically higher intraoperative glucose levels (272.76 +/- 55.92 vs. 182.79 +/- 45, p value = .0001). There was no difference in postoperative mortality, sternal wound infections or stroke incidence, nor in other secondary outcomes. The type of cardioplegia solution was shown to affect glucose levels; however, there was no effect on postoperative complication rates.
authors.affiliation: North Shore-LIJ Health System, Great Neck, New York 11021, USA.
authors.forename: Ronald
authors.initials: R
authors.lastname: Lessen
authors.forename: John
authors.initials: J
authors.lastname: DiCapua
authors.forename: Renee
authors.initials: R
authors.lastname: Pekmezaris
authors.forename: Rajni
authors.initials: R
authors.lastname: Walia
authors.forename: Karl
authors.initials: K
authors.lastname: Bocchieri
authors.forename: Lynda
authors.initials: L
authors.lastname: Jahn
authors.forename: Meredith
authors.initials: M
authors.lastname: Akerman
authors.forename: Martin L
authors.initials: ML
authors.lastname: Lesser
authors.forename: Alan
authors.initials: A
authors.lastname: Hartman
mesh_terms: D000328:Adult; D000368:Aged; D002314:Cardioplegic Solutions / Q000627:therapeutic use*; D013504:Cardiovascular Surgical Procedures / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D005947:Glucose / Q000627:therapeutic use*; D006324:Heart Arrest, Induced / Q000401:mortality*; D006801:Humans; D006943:Hyperglycemia / Q000401:mortality*; D008297:Male; D009518:New York / Q000453:epidemiology; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D002314:Cardioplegic Solutions; D005947:Glucose