Document Detail

Cardiac function after intermittent antegrade warm blood cardioplegia: contribution of the double-indicator dilution technique.
MedLine Citation:
PMID:  10945384     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate cardiac performance following coronary artery surgery using two different techniques of cardioplegia. DESIGN: Randomized prospective study. SETTING: Adult cardiothoracic intensive care unit in a university hospital. STUDY POPULATION: Thirty patients undergoing isolated coronary surgery. INTERVENTIONS: Patients were randomized to receive either intermittent antegrade warm blood cardioplegia with normothermic bypass (group 1) or combined antegrade and retrograde cold crystalloid cardioplegia with hypothermic bypass (group 2). Hemodynamic evaluation included conventional measurements from a pulmonary artery catheter and data obtained by thermal dye dilution utilizing an arterial thermistor-tipped fiberoptic catheter. RESULTS: The only major difference between groups was a significantly higher right atrial pressure in group 2, from 4 h to 24 h after surgery (8.8 +/- 2.6 vs. 11.8 +/- 3.2 mmHg at 4 h and 11 +/- 3.1 vs. 8.5 +/- 1.8 mmHg at 24 h, P = 0.04). After cold cardioplegia a significant increase in right atrial pressure was observed (7.5 +/- 3.1 before surgery vs. 11.4 +/- 3 mmHg at 8 h, P = 0.003) whereas right ventricular end diastolic volume index did not increase significantly, suggesting impaired right ventricular diastolic compliance in this group. CONCLUSIONS: Until 24 h after surgery cold cardioplegia is associated with impaired right ventricular filling, which seems better preserved by intermittent antegrade warm blood cardioplegia. End-diastolic volume measurement with the double-indicator technique allows differentiation between systolic and diastolic dysfunction.
L Jacquet; P Honore; R Beale; D Valadi; R Dion; M Goenen
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Intensive care medicine     Volume:  26     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2000 Jun 
Date Detail:
Created Date:  2000-11-21     Completed Date:  2000-12-22     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  686-92     Citation Subset:  IM    
Cardiothoracic Intensive Care Unit, University Hospital Saint-Luc, Brussels, Belgium.
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MeSH Terms
Analysis of Variance
Cardiac Output
Coloring Agents / diagnostic use
Coronary Artery Bypass*
Fiber Optic Technology
Heart Arrest, Induced / methods*
Indocyanine Green / diagnostic use
Prospective Studies
Thermodilution / instrumentation,  methods*
Time Factors
Reg. No./Substance:
0/Coloring Agents; 3599-32-4/Indocyanine Green

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