Diltiazem cardioplegia
| Autor: | Richard D. Weisel, Ronald J. Baird, Jacques G. Tittley, Arnold M. Benak, Donald A.G. Mickle, George T. Christakis, Stephen E. Fremes, Joan Ivanov, Peter R. McLaughlin, M. Mindy Madonik |
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| Rok vydání: | 1986 |
| Předmět: |
Pulmonary and Respiratory Medicine
business.industry Heart block Ischemia Hemodynamics medicine.disease Creatine law.invention chemistry.chemical_compound chemistry law Anesthesia Cardiopulmonary bypass medicine Surgery Diltiazem Cardiology and Cardiovascular Medicine business Reactive hyperemia Perfusion medicine.drug |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 91:647-661 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/s0022-5223(19)35984-7 |
| Popis: | Calcium channel blockers may prevent myocardial injury during cardioplegia and reperfusion. A prospective, randomized trial was instituted to evaluate the hemodynamic and myocardial metabolic recovery in 40 patients undergoing elective aorta-coronary bypass with either diltiazem in crystalloid potassium cardioplegia (n = 20) or crystalloid potassium cardioplegia (n = 20). In a preliminary trial, doses between 150 and 250 μg/kg reduced the period of heart block after cross-clamp removal (90 ± 110 minutes) from that found with higher doses and improved myocardial metabolism. In the randomized trial, diltiazem cardioplegia (150 μg/kg) produced coronary vasodilatation during cardioplegia and produced less reactive hyperemia during reperfusion. Myocardial oxygen extraction was lower and myocardial lactate production was less after diltiazem cardioplegia during reperfusion. Tissue adenosine triphosphate and creatine phosphate concentrations were preserved better after diltiazem cardioplegia. The postoperative creatine kinase MB levels were less (p |
| Databáze: | OpenAIRE |
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