| Comparison of standard (non-oxygenated) vs. oxygenated St. Thomas' Hospital cardioplegic solution No. 2 (Plegisol). | |
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MedLine Citation:
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PMID: 2245049 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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) |
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Authors:
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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:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 1991-01-09 Completed Date: 1991-01-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: GERMANY |
Other Details:
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Languages: eng Pagination: 549-55 Citation Subset: IM |
Affiliation:
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Cardiovascular Research (Surgical Cytochemistry), Rayne Institute, St. Thomas' Hospital, London, UK. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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