Randomized trial of intermittent antegrade warm blood versus cold crystalloid cardioplegia
| Autor: | Michel Van Dyck, Philippe Noirhomme, Martin Goenen, Robert Dion, Amin Matta, G. Khoury, Luc Jacquet |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Myocardial Infarction Hemodynamics Anastomosis Body Temperature law.invention Postoperative Complications Randomized controlled trial law Cardiopulmonary bypass medicine Humans Derivation Coronary Artery Bypass Cardioplegic Solutions Aged biology business.industry Central venous pressure Middle Aged Hypothermia Troponin Survival Rate Blood Anesthesia Electrocardiography Ambulatory Heart Arrest Induced biology.protein Female Surgery medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 67:471-477 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/s0003-4975(98)01198-9 |
| Popis: | BACKGROUND: We performed a prospective randomized trial to compare intermittent antegrade warm blood cardioplegia with intermittent antegrade and retrograde cold crystalloid cardioplegia. METHODS: Two hundred consecutive patients scheduled for isolated coronary bypass surgical procedures were randomized into two groups: Group 1 (n = 92) received cold crystalloid cardioplegia with moderate systemic hypothermia, group 2 (n = 108) received intermittent antegrade warm blood cardioplegia with systemic normothermia. Preoperative, intraoperative, and postoperative data were prospectively collected. RESULTS: For the same median number of distal anastomoses, cardiopulmonary bypass duration and total ischemic arrest duration (57.3 +/- 20.5 versus 75 +/- 22.1 minutes, p < 0.001) were shorter in group 2 than in group 1. Apart from a higher right atrial pressure in the cold cardioplegia group, no hemodynamic difference was observed. Aspartate aminotransferase, creatine kinase-MB fraction, and cardiac troponin I levels were significantly lower in group 2 than in group 1. Outcome variables were not significantly different. CONCLUSIONS: Intermittent antegrade warm blood cardioplegia results in less myocardial cell damage than cold crystalloid cardioplegia, as assessed by the release of cardiac-specific markers. This beneficial effect has only marginal clinical consequences. Normothermic bypass has no deleterious effect on end-organ function. |
| Databáze: | OpenAIRE |
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