Use of Undiluted Potassium Solution in Intermittent Antegrade Warm Blood Cardioplegia (IAWBC).
- Author:
Joung Taek KIM
1
;
Wan Ki BAEK
;
Kuk Hee SON
;
Young Sam KIM
;
Yong Han YOON
;
Hae Sook KIM
;
Hyun Kyoung LIM
;
Choon Soo LEE
;
Kwang Ho KIM
Author Information
1. Department of Thoracic & Cardiovascular Surgery, and Departement of Aneshtesiology, College of Medicine, Inha University, Korea. jtkim@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Cardioplegia;
Potassium;
Heart arrest, induced
- MeSH:
Blood Transfusion;
Body Temperature;
Cardiopulmonary Bypass;
Constriction;
Coronary Circulation;
Erythrocytes;
Heart Arrest, Induced*;
Hematocrit;
Hemofiltration;
Hospital Mortality;
Humans;
Myocardial Infarction;
Oxygen;
Oxygenators;
Potassium*;
Stroke Volume;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2004;37(8):660-664
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Dilution of blood cardioplegia is not needed in IAWBC as it is in cold blood cardioplegia because it does not aggregate red blood cells on normal body temperature and does not compromise micro coronary circulation. This study was designed to evaluate the safety and efficacy of undiluted potassium solution in IAWBC. MATERIAL AND METHOD: Thirty patients who underwent CABG with IAWBC were grouped into dilutedplegia (n=14) and microplegia (n=16). Potassium was delivered conventionally with 4:1 delivery kit in the dilutedplegia group. The undiluted potassium was directly connected on the blood of oxygenator in the microplegia group. RESULT: There were no differences in sex, age, left ventricular ejection fraction, number of grafts, aortic cross clamping time, and the value of perioperative myocardial enzyme between the two groups. There were no perioperative myocardial infarction and hospital mortality. The amount of crystalloid cardioplegia was 1346+/-597 mL in dilutedplegia (mean+/-standard deviation, and 28+/-9 mL in microplegia (p<0.0001). The hematocrit during cardiopulmonary bypass was 21+/-4% in dilutedplegia and 24+/-3% in microplegia (p>0.05). 11 patients in dilultedplegia received blood transfusion, but 4 patients in microplegia received blood transfusion (p<0.05). The amount of urine and hemofiltration during the operation were more in dilutedplegia (1250+/-810 mL, 1689+/-548 mL) than in microplegia (959+/-410 mL, 1481+/-784 mL; p<0.05). CONCLUSION: The undiluted potassium of IAWBC in CABG operation is a safe, effective technique for myocardial protection to prevent fluid overload, and blood transfusion. There is no need to use the delivery kit.
