Is high potassium solution necessary for reinfusions in 'multidose' cold cardioplegia? A randomized prospective study using computerized Holter system
| Autor: | Michael Dewar, Carin Wittnich, Michael D. Rosengarten, Ray C.-J. Chiu, Peter E. Blundell, Roger Samson |
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| Rok vydání: | 1987 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Holter monitor Potassium Compounds Potassium Electrical stability chemistry.chemical_element Hemodynamics Common method law.invention Electrocardiography Intraoperative Period Random Allocation law Cardiopulmonary bypass medicine Humans Postoperative Period Prospective Studies Prospective cohort study Monitoring Physiologic Cardiopulmonary Bypass medicine.diagnostic_test business.industry Heart chemistry Anesthesia Heart Arrest Induced Myocardial preservation Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of thoracic surgery. 43(4) |
| ISSN: | 0003-4975 |
| Popis: | Multidose potassium cardioplegia is a common method of myocardial preservation. Although initial potassium arrest conserves high-energy phosphates, there is conflicting evidence that repeat high potassium boluses augment this protection. Fifty-six patients were prospectively randomized to receive multidose cold high potassium cardioplegia (27 mEq of KCl/L) both in the initial and subsequent infusions (Group 1) or an initial cold high potassium (27 mEq/L) cardioplegia followed by boluses of cold low potassium (7 mEq, of KCl/L) solution (Group 2). The two groups were compared in terms of postoperative myocardial electrical stability and hemodynamic performance. Electrocardiograms were recorded by continuous Holter monitor, and the data were analyzed by computer. The duration of aortic cross-clamping and cardiopulmonary bypass did not differ between groups. Group 1, who received more total KCl than Group 2 (p less than .005), experienced more high-grade ventricular ectopia during both reperfusion (p less than .001) and the immediate postoperative period (p less than .001), and required more lidocaine hydrochloride (p less than .001) for arrhythmias. There was no significant difference in hemodynamic performance between the two groups. This study fails to show an advantage to multidose "high potassium" cardioplegia and found a significant increase in ventricular ectopia associated with its use. We advocate using low potassium solutions after initial cold high potassium arrest. |
| Databáze: | OpenAIRE |
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