The myocardial protective effects of a moderate-potassium adenosine–lidocaine cardioplegia in pediatric cardiac surgery

Objectives We sought to evaluate a moderate-potassium cardioplegic solution using adenosine and lidocaine as the arresting and protecting cardioprotective combination in pediatric cardiac surgery. Methods One hundred thirty-four patients with congenital heart disease were randomly allocated to one o...

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Published in:The Journal of thoracic and cardiovascular surgery 2008-12, Vol.136 (6), p.1450-1455
Main Authors: Jin, Zhen-Xiao, MD, PhD, Zhang, Sheng-Li, MD, Wang, Xi-Ming, MD, Bi, Sheng-Hui, MD, Xin, Mei, MD, Zhou, Jing-Jun, PhD, Cui, Qin, MD, PhD, Duan, Wei-Xun, MD, PhD, Wang, Hong-Bing, MD, Yi, Ding-Hua, MD, PhD
Format: Article
Language:English
Subjects:
Adenosine - administration & dosage
Adenosine - pharmacology
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiac Surgical Procedures
Cardiology. Vascular system
Cardioplegic Solutions - administration & dosage
Cardioplegic Solutions - pharmacology
Cardiopulmonary Bypass
Cardiothoracic Surgery
Cardiotonic Agents - administration & dosage
Cardiotonic Agents - pharmacology
Child, Preschool
Female
Heart - drug effects
Heart Defects, Congenital - surgery
Humans
Infant
Lidocaine - administration & dosage
Lidocaine - pharmacology
Male
Medical sciences
Myocardium
Pneumology
Potassium - administration & dosage
Potassium - pharmacology
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
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Summary:Objectives We sought to evaluate a moderate-potassium cardioplegic solution using adenosine and lidocaine as the arresting and protecting cardioprotective combination in pediatric cardiac surgery. Methods One hundred thirty-four patients with congenital heart disease were randomly allocated to one of 3 groups according to the cardioplegia formula used: the high-potassium (HP) group (K+ , 20 mmol/L), 46 patients; the high-potassium adenosine–lidocaine (HPAL) group (K+ , 20 mmol/L; adenosine, 0.7 mmol/L; and lidocaine, 0.7 mmol/L), 44 patients; and the moderate-potassium adenosine–lidocaine (MPAL) group (K+ , 10 mmol/L; adenosine, 0.7 mmol/L; and lidocaine, 0.7 mmol/L), 44 patients. Hemodynamic data during the operation and postoperative data were recorded. Serum cardiac troponin I concentrations were examined at the time points of before cardiopulmonary bypass and 1, 3, 6, 12, and 24 hours after aortic crossclamp removal. Results At the end of cardiopulmonary bypass and modified ultrafiltration, the systolic and pulse pressures of the MPAL group were significantly increased compared with the respective values of the HP group. At the time points of 1 to 12 hours after reperfusion, the levels of serum cardiac troponin I were significantly decreased in the MPAL group compared with those in the HP and HPAL groups. Conclusions The MPAL cardioplegia formula was associated with better myocardial protective effects.
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2008.03.025