Comparison of Lactated Ringer's Solution and PlasmaLyte-A as a Base Solution for Del Nido Cardioplegia
Completed
Mahidol University
N/A
2019-08-05
Del Nido cardioplegia has been used exclusively for myocardial protection in pediatrics
cardiac surgery for decades. Its unique properties including lidocaine which helps counteract
potassium depolarization of the myocardial cell membrane, inhibition of intracellular calcium
accumulation, preservation of intracellular high-energy phosphates, free-radical scavenging
and acid-base buffering have been proven to be very effective for myocardial protection
during cardiac surgery for congenital heart disease and acquired heart disease. Recent
studies have proven its safety, efficacy, and cost-effectiveness for myocardial protection in
adult cardiac surgery as a single dose cardioplegia which is typically administered in a
single dose fashion or with extended dosing intervals. In contrast, Traditional blood
cardioplegia is commonly administered approximately every 20 minutes. These characteristics
of del Nido cardioplegia allow for fewer interruptions and improve surgical workflow. The
base solution for del Nido cardioplegia is normally Plasma-Lyte A (Baxter Healthcare
Corporation, Deerfield, IL, USA) which has an electrolyte composition similar to the
extracellular fluid and is calcium-free. Unfortunately, an unavailability of PlasmaLyte-A in
many countries precluding utilization of del Nido cardioplegia with its normal base solution
in many cardiac centers. To access the benefits of del Nido cardioplegia, we utilize lactated
Ringer's solution as the base solution. This prospective randomized study aimed to evaluate
myocardial preservation and clinical outcomes when using lactated Ringer's solution compared
with PlasmaLyte-A as a base solution for del Nido cardioplegia.
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