Abstract
BackgroundDel Nido cardioplegia (DNC) has been proven safe and effective in pediatric patients. However, the use of DNC in adult undergoing cardiovascular surgery lacks support with substantial evidence. This study aimed to evaluate the efficacy of DNC as a cardioplegia of prophylaxis to ventricular arrhythmias associated to cardiovascular surgery in adult patients.MethodsThis study recruited nine hundred fifty-four patients who underwent cardiopulmonary bypass surgeries in Nanjing Hospital affiliated to Nanjing Medical University between January 2019 and December 2019. Among 954 patients, 324 patients were treated with DNC (DNC group), and 630 patients were treated with St. Thomas cardioplegia (STH group). The incidence of postoperative arrhythmia as well as other cardiovascular events relavant to the surgery were investigated in both groups.ResultsIn DNC group, the incidence of postoperative ventricular arrhythmias was lower (12.4% vs. 17.4%, P = 0.040), and the length of ICU stay was shorter (1.97 ± 1.49 vs. 2.26 ± 1.46, P = 0.004). Multivariate logistic regression demonstrated that the use of DNC helped to reduce the incidence of postoperative ventricular arrhythmias (adjusted odds ratio 0.475, 95% CI 0.266–0.825, P = 0.010). The propensity score-based analysis and subgroup analysis indicated that DNC has the same protecting effects towards myocardial in all kinds of cardiopulmonary bypass surgeries.ConclusionsDel Nido cardioplegia may potentially reduce the incidence of postoperative ventricular arrhythmias, shorten the length of ICU stay and improve the overall outcome of the patients undergoing cardiovascular surgery.
Highlights
Del Nido cardioplegia (DNC) has been proven safe and effective in pediatric patients
A total of 954 patients were enrolled in the study and were divided into Del Nido cardioplegia group (DNC group, n = 324) and St
Our study showed that DNC may reduce the incidence of postoperative ventricular arrhythmias
Summary
Del Nido cardioplegia (DNC) has been proven safe and effective in pediatric patients. The use of DNC in adult undergoing cardiovascular surgery lacks support with substantial evidence. This study aimed to evaluate the efficacy of DNC as a cardioplegia of prophylaxis to ventricular arrhythmias associated to cardiovascular surgery in adult patients. DNC is a cold blood cardioplegia modified with a higher level of potassium. It was initially developed by Professor Pedro Del Nido at the University of Pittsburgh given the use in children’s immature myocardium [3]. Beyond the use in pediatrics, multiple animal experiments and clinical trials have proven that DNC can excellently protect the mature myocardium [4,5,6,7]
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