title: Comparison of high glucose concentration blood and crystalloid cardioplegia in paediatric cardiac surgery: a randomized clinical trial.
abstract: This study investigates the effects of high glucose content on patients undergoing cold crystalloid versus cold blood cardioplegia in terms of early clinical results, functional myocardial recovery and ischaemia-reperfusion injury in patients undergoing repair of acyanotic cardiac lesions.
  
  
  
  Patients were randomly assigned to receive either crystalloid (n = 31) or blood cardioplegia (n = 31). Early clinical results were assessed. Changes in left ventricular fractional shortening, arterial blood lactate levels, central venous saturation, cardiac Troponin I release and blood glucose concentration were measured during the first 24 h after ischaemia.
  
  
  
  There was no significant difference in clinical outcomes and postoperative complication rates between groups. The postoperative changes in left ventricular function, lactate levels, central venous saturation and Troponin I were not significantly different between groups. The use of crystalloid cardioplegia was associated with significant increases in serum glucose compared with blood cardioplegia.
  
  
  
  A high glucose content blood cardioplegia does not show any advantage compared with crystalloid cardioplegia in terms of clinical outcomes, functional recovery and the degree of ischaemic injury in infants and children undergoing repair of acyanotic heart lesions. High glucose concentration of the cardioplegic solution might potentiate ischaemia-reperfusion injury and diminish the beneficial effects of blood cardioplegia.
authors.affiliation: Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK brankomimic@gmail.com.
authors.forename: Branko
authors.initials: B
authors.lastname: Mimic
authors.affiliation: Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Ilic
authors.affiliation: Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia.
authors.forename: Irena
authors.initials: I
authors.lastname: Vulicevic
authors.affiliation: Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Milovanovic
authors.affiliation: Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia.
authors.forename: Danijela
authors.initials: D
authors.lastname: Tomic
authors.affiliation: Department of Anaesthesiology, Clinical Centre of Serbia, Belgrade, Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Mimic
authors.affiliation: Centre for Medical Biochemistry, Clinical Centre of Serbia, Belgrade, Serbia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Stankovic
authors.affiliation: Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Zecevic
authors.affiliation: Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK.
authors.forename: Ben
authors.initials: B
authors.lastname: Davies
authors.affiliation: School of Medicine, University of Belgrade, Belgrade, Serbia Department of Urology, University Children's Hospital, Belgrade, Serbia.
authors.forename: Miroslav
authors.initials: M
authors.lastname: Djordjevic
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002675:Child, Preschool; D000077324:Crystalloid Solutions; D004305:Dose-Response Relationship, Drug; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006324:Heart Arrest, Induced / Q000379:methods*; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007223:Infant; D007552:Isotonic Solutions / Q000494:pharmacology*; D008297:Male; D015428:Myocardial Reperfusion Injury / Q000453:epidemiology / Q000517:prevention & control; D055771:Serbia / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000187:drug effects*
chemical_list: D001786:Blood Glucose; D000077324:Crystalloid Solutions; D007552:Isotonic Solutions; D005947:Glucose
keywords: Blood cardioplegia; High glucose concentration; Myocardial protection; Paediatric cardiac surgery
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