The Influence of Continuous Warm Blood Cardioplegia on Intraoperative Cardiac Aerobic Metabolism / 日本心臓血管外科学会雑誌

ABSTRACT

Continuous warm blood cardioplegia (CWBC) was compared with cold crystalloid cardioplegia (CCC) with regard to intraoperative cardiac aerobic metabolism. Thirty-six adult patients who underwent CABG were divided into two groups. The CWBC group (<i>n</i>=21) received continuous warm blood cardioplegia while the CCC group (<i>n</i>=15) received 4°C St. Thomas' Hospital cardioplegic solution. Some parameters of cardiac anaerobic metabolism were measured intraoperatively. We continuously measured the oxygen saturation of coronary sinus blood (ScsO₂) after aortic declamping until 5 minutes after cardiopulmonary bypass (CPB). CK and CK-MB levels were measured at admission to ICU, and on the first and second postoperative day (POD) in both groups. CPB time, aortic-cross clamp time and incidence of postoperative low output syndrome were similar in the two groups. The spontaneous return to sinus rhythm after aortic declamping was significantly higher in the CWBC group. ScsO₂ was significantly higher in the CWBC group. The lactate uptake ratio of myocardium, excess lactate and redox potential were similar in the two groups. CK and CK-MB levels were significantly lower in the CWBC group. We concluded that the CWBC group was superior to the CCC group in terms ScsO₂, CK and CK-MB levels. Other parameters of cardiac anaerobic metabolism were similar in the two groups.