Document Detail


Protection of the neonatal heart following normothermic ischemia: a comparison of oxygenated saline and oxygenated versus nonoxygenated cardioplegia.
MedLine Citation:
PMID:  3377577     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Optimal methods of myocardial preservation in the neonate remain unknown. Hypothermia and cardioplegia have been shown to protect neonatal hearts, but few studies have examined the effects of cardioplegia when administered at normothermia. Accordingly, the role of 37 degrees C St. Thomas' cardioplegic solution in protecting the neonatal heart during 1 hour of ischemia in an isolated working rabbit heart model was examined. Both oxygenated and nonoxygenated cardioplegic solutions (CSs) were evaluated and compared with an oxygenated physiological saline solution (PSS). Following ischemia, control hearts were characterized by severely impaired left ventricular function, whereas all three treatment groups recovered well, indicating that the treatments provided substantial protection. Aortic flow recovered to 62, 63, and 57% of preischemic values for the oxygenated CS, nonoxygenated CS, and oxygenated PSS groups, respectively. Similarly, rate of change of pressure recovered to 76, 80, and 76% of preischemic values for oxygenated CS, nonoxygenated CS, and oxygenated PSS groups. All values were significantly greater than those for the control group. Recovery of developed pressure was significantly improved in all three groups. End-diastolic pressure rose markedly following ischemia in control hearts, was not increased after ischemia in hearts receiving oxygenated and nonoxygenated CS, but was increased in the oxygenated PSS group. These data indicate that crystalloid cardioplegia and oxygenated PSS provide substantial protection in neonatal rabbit hearts, even when delivered at 37 degrees C. No additional benefit was seen when the cardioplegic solution was oxygenated. Therefore, either method of balancing the oxygen supply/demand ratio appears to be beneficial: supplying oxygen intermittently during ischemia (oxygenated PSS group) or decreasing oxygen demand during the ischemic period (cardioplegia groups).
Authors:
M J Lynch; E L Bove; T N Zweng; M H Fox; S F Bolling; K P Gallagher
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  45     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1988 Jun 
Date Detail:
Created Date:  1988-07-06     Completed Date:  1988-07-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  650-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Michigan Medical School, Ann Arbor 48109-0344.
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MeSH Terms
Descriptor/Qualifier:
Animals
Animals, Newborn*
Bicarbonates
Calcium Chloride
Cardioplegic Solutions*
Coronary Circulation
Heart*
Heart Arrest, Induced*
Magnesium
Myocardial Contraction
Myocardium / metabolism
Oxygen*
Oxygen Consumption
Perfusion
Potassium Chloride
Rabbits
Sodium Chloride
Chemical
Reg. No./Substance:
0/Bicarbonates; 0/Cardioplegic Solutions; 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

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


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