Document Detail

Detrimental effects of temperature on the efficacy of the University of Wisconsin solution when used for cardioplegia at moderate hypothermia. Comparison with the St. Thomas Hospital solution at 4 degrees C and 20 degrees C.
MedLine Citation:
PMID:  1424014     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We have previously reported the superior protective properties of the University of Wisconsin (UW) solution compared with the St. Thomas solution (ST) in the rat heart subjected to the deep hypothermia (4 degrees C), thus demonstrating its possible use in cardiac transplantation. We thought it was important to evaluate the potential of the UW solution as a cardioplegic solution under the moderately hypothermic (20 degrees C) conditions of routine intraoperative myocardial protection. METHODS AND RESULTS: Isolated rat hearts were subjected to 60 minutes of ischemia at 4 degrees C or 30 (or 60) minutes of ischemia at 20 degrees C with UW, ST, and ST plus 100 mM K (ST + 100) solutions. Coronary flow, mechanical function, endothelial function, and ultrastructure were observed. Mean time (seconds) to infuse 10 ml of cardioplegic solution under constant pressure, a measure of coronary vascular resistance at 4 degrees C and 20 degrees C, respectively, for each solution were ST, 69.2 +/- 6.9 and 64.7 +/- 3.8; UW, 142.2 +/- 8.8 and 187.2 +/- 10.0 (p < 0.01); and ST + 100, 78.2 +/- 8.0 and 176 +/- 8.1 (p < 0.001). Mean recovery values of cardiac output (expressed as percentage of its preischemic value) after 60 minutes of ischemia at 4 degrees C were ST, 95.5 +/- 2.1%; UW, 93.0 +/- 2.4%; and ST + 100, 96.5 +/- 1.5%. After 30 minutes of ischemia at 20 degrees C, values were ST, 88.0 +/- 1.3%; UW, 72.2 +/- 3.6% (p < 0.005 versus ST); and ST + 100, 53.3 +/- 1.8% (p < 0.001 versus ST). CONCLUSIONS: The efficacies of UW and severely hyperkalemic cardioplegic solutions are affected by the degree of hypothermia under which they are used. Under moderate hypothermia (20 degrees C), severe hyperkalemia induces a marked increase in coronary vascular resistance that is associated with impaired myocardial protection. These studies discourage the use of UW for routine intraoperative cardioplegic arrest where the degree of hypothermia cannot be readily controlled. The ST solution does not share this constraint.
M Amrani; S Ledingham; J Jayakumar; N J Allen; S Rothery; N Severs; M Yacoub
Related Documents :
10554854 - Cardiac troponin t release during coronary surgery using intermittent cross-clamp with ...
15216184 - Iatrogenic myocardial dysfunction after formalization of the heart.
335264 - Acute hyperkalemia risks in recipients of kidney graft cooled with collins' solution.
17410074 - Selective antegrade cardioplegic perfusion complicated by left main stem dissection.
9403614 - Three-dimensional mapping of the common atrial flutter circuit in the right atrium.
1155334 - Left main coronary artery disease. risks of angiography, importance of coexisting disea...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  86     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-02     Completed Date:  1992-12-02     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  II280-8     Citation Subset:  AIM; IM    
Department of Cardiothoracic Surgery, National Heart and Lung Institute, London, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Bicarbonates / pharmacology
Calcium Chloride / pharmacology
Cardioplegic Solutions / pharmacology*
Endothelium, Vascular / drug effects
Heart Arrest, Induced / methods*
Hypothermia, Induced
Magnesium / pharmacology
Muscle, Smooth, Vascular / drug effects
Myocardial Reperfusion Injury / prevention & control*
Organ Preservation Solutions*
Potassium Chloride / pharmacology
Rats, Sprague-Dawley
Sodium Chloride / pharmacology
Solutions / pharmacology
Reg. No./Substance:
0/Bicarbonates; 0/Cardioplegic Solutions; 0/Organ Preservation Solutions; 0/Solutions; 0/St. Thomas' Hospital cardioplegic solution; 0/University of Wisconsin-lactobionate solution; 10043-52-4/Calcium Chloride; 11061-68-0/Insulin; 315-30-0/Allopurinol; 512-69-6/Raffinose; 58-61-7/Adenosine; 70-18-8/Glutathione; 7439-95-4/Magnesium; 7447-40-7/Potassium Chloride; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  The implantable defibrillator: an electronic bridge to cardiac transplantation.
Next Document:  In vitro assessment of the effects of glucose added to the University of Wisconsin solution on myocy...