Document Detail


Tepid antegrade and retrograde cardioplegia.
MedLine Citation:
PMID:  7887719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the optimal temperature for the combination of antegrade and retrograde cardioplegia, 42 patients undergoing coronary artery bypass grafting were randomized to receive cold (9 degrees C; n = 14), tepid (29 degrees C; n = 14), or warm (37 degrees C; n = 14) blood cardioplegia delivered continuously retrograde and intermittently antegrade. Myocardial oxygen utilization, lactate and acid metabolism, and coronary vascular resistance were measured during the operation and cardiac function was assessed postoperatively. Myocardial oxygen consumption, lactate release and acid release were greatest with warm, intermediate with tepid, and least with cold cardioplegia (p = 0.0001). However, washout of lactate and acid at the time of cross-clamp release was reduced (p = 0.022) with tepid or cold compared with warm cardioplegia. Early postoperative left ventricular function was best preserved (p = 0.01) after tepid than after cold or warm combination cardioplegia. These results suggest that tepid combination cardioplegia reduced metabolic demands but permitted immediate recovery of cardiac function. This technique may provide better myocardial protection than cold or warm combination cardioplegia.
Authors:
N Hayashida; R D Weisel; T Shirai; J S Ikonomidis; J Ivanov; S M Carson; M K Mohabeer; L C Tumiati; D A Mickle
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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:  The Annals of thoracic surgery     Volume:  59     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-04-07     Completed Date:  1995-04-07     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:  723-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Clinical Biochemistry, Toronto Hospital, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Analysis of Variance
Blood Flow Velocity
Blood Pressure
Coronary Artery Bypass / methods*
Coronary Circulation
Coronary Disease / metabolism,  physiopathology,  surgery*
Female
Heart Arrest, Induced / methods*
Heart Rate
Humans
Intraoperative Care
Lactates / metabolism
Lactic Acid
Male
Middle Aged
Oxygen Consumption
Postoperative Care
Temperature*
Vascular Resistance
Ventricular Function, Left
Chemical
Reg. No./Substance:
0/Lactates; 50-21-5/Lactic Acid

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


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