Document Detail


Comparison of standard (non-oxygenated) vs. oxygenated St. Thomas' Hospital cardioplegic solution No. 2 (Plegisol).
MedLine Citation:
PMID:  2245049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent studies have suggested that oxygenation of crystalloid cardioplegic solutions improves myocardial preservation. To assess whether oxygenation of St. Thomas' Hospital cardioplegic solution No. 2 (Plegisol) improves its clinical efficacy, 50 patients were randomly assigned into 2 groups: (1) those receiving Plegisol and (2) those receiving O2-Plegisol (PO2 greater than 500 mmHg at 4 degrees C). Efficacy was assessed by (a) clinical and haemodynamic parameters, (b) quantitative birefringence changes in response to ATP and calcium as a measurement of myocardial preservation in left and right ventricular biopsies, (c) creatine kinase (MB isoenzyme) release for up to 4 days postoperatively, (d) electrocardiographic (ECG) monitoring for up to 7 days postoperatively. There were no differences in mean age, ejection fraction, aortic cross-clamp duration, or bypass duration between the 2 groups of patients. In the Plegisol group, 2 patients (8%) died and 4 patients (16%) required inotropic support, whereas in the O2-Plegisol group there were no deaths and only 2 patients (8%) required inotropic support. These differences, however, were not statistically significant. Birefringence assessment demonstrated an improved myocardial response to ATP and calcium (predominantly in the left ventricular epimyocardium and in the right ventricular biopsies) at the end of ischaemia and after reperfusion in patients given O2-Plegisol. Deterioration in cellular assessment of myocardial contractility (measured by a reduction in birefringence of greater than 0.4 nm) was reduced from 20% in Plegisol patients to 12.5% in O2-Plegisol patients. CK-MB values showed no difference at any sampling time between the 2 groups of patients; a mean peak CK-MB of 35 IU/l occurred 2 h postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D J Chambers; S Kosker; A Takahashi; A Sakai; S Baharakakis; G Manzanera; R A Jupp; L D Smith; M V Braimbridge
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  4     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1990  
Date Detail:
Created Date:  1991-01-09     Completed Date:  1991-01-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  549-55     Citation Subset:  IM    
Affiliation:
Cardiovascular Research (Surgical Cytochemistry), Rayne Institute, St. Thomas' Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Bicarbonates
Biopsy
Calcium Chloride
Coronary Artery Bypass
Creatine Kinase / blood
Electrocardiography
Female
Heart Valves / surgery
Humans
Magnesium
Male
Middle Aged
Myocardial Reperfusion Injury / pathology
Myocardium / pathology
Oxygen
Potassium Chloride
Sodium Chloride
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/St. Thomas' Hospital cardioplegic solution; 10043-52-4/Calcium Chloride; 7439-95-4/Magnesium; 7447-40-7/Potassium Chloride; 7647-14-5/Sodium Chloride; 7782-44-7/Oxygen; EC 2.7.3.2/Creatine Kinase

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