Comparison of the operative and postoperative effects of del Nido and blood cardioplegia solutions in cardiopulmonary bypass surgery.

Yavuz Orak,Omer Faruk Boran,Aydemir Kocarslan,Mehmet Acıpayam,Mehmet Kirisci,Adem Doganer,Erdinc Eroglu

doi:10.21470/1678-9741-2019-0436

Yavuz Orak, Omer Faruk Boran + Show 5 more

Open Access

https://doi.org/10.21470/1678-9741-2019-0436

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Abstract

ObjectiveOur goal was to compare the operative and postoperative effects of del Nido cardioplegia (DN group) and blood cardioplegia (BC group) performed in cardiac surgery.MethodsA total of 83 patients were included, separated into DN group and BC group. The operative and postoperative effects of the two groups were compared for the first 24 hours until extubation. The operative and postoperative complete blood count (CBC), biochemical values and clinical parameters were compared.ResultsThe first control activated clotting time (ACT) levels in DN group patients were lower (P=0.003) during the operation. The amount of cardioplegia in DN group were lower than that in BC group (P=0.001). The pump outflow and postoperative lactate level of DN group were lower than those of BC group (P=0.005, P=0.018, respectively), as well as the amounts of NaHCO3 (P=0.006) and KCl (P=0.001) used during the operation. The same occurred with the first monocytes (Mo) and mean corpuscular volume (MCV) levels in the postoperative intensive care unit (P=0.006, P=0.002). However, the first glucose level and the eosinophil (Eo) level were higher in DN group (P=0.011, P=0.047, respectively).ConclusionIn the operative evaluation, the amount of cardioplegia, the first ACT levels, the pump outflow lactate level and the amounts of NaHCO3 and KCl in DN group were lower. In postoperative evaluation, measured level of lactate, Mo and MCV in DN group were all lower; their glucose and Eo levels were higher.

Highlights

In cardiac surgery, the myocardial injury sustained during the operation is the most important cause of mortality and morbidity
The same occurred with the first monocytes (Mo) and mean corpuscular volume (MCV) levels in the postoperative intensive care unit (P=0.006, P=0.002)
The first glucose level and the eosinophil (Eo) level were higher in DN group (P=0.011, P=0.047, respectively)

Summary

Introduction

The myocardial injury sustained during the operation is the most important cause of mortality and morbidity. Cardioplegia, as well as local and systemic hypothermia, have been used in cardiac surgery for many years for myocardial protection[3,4]. The causes of myocardial damage are global myocardial ischemia (aortic crossclamp) and especially reperfusion[5]. Researchers at the University of Pittsburgh (Pittsburgh, PA) developed a new formulation for myocardial protection in the early 1990s. This team, led by Pedro del Nido, Hung Cao-Danh, K. Changes have been made to the original solution and, in the literature, its use in clinical practice is referred to as del Nido cardioplegia[9]

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