Issue |
J Extra Corpor Technol
Volume 56, Number 3, September 2024
|
|
---|---|---|
Page(s) | 84 - 93 | |
DOI | https://doi.org/10.1051/ject/2024011 | |
Published online | 20 September 2024 |
Original Article
Comparison of routine del Nido cardioplegia vs two types of modified del Nido cardioplegias for myocardial protection among patients undergoing coronary artery bypass grafting (CABG) surgeries: A randomized double-blind clinical trial
1
Student Research Committee of Shiraz University of Medical Sciences, PO BOX 71348-14336, Shiraz, Iran
2
Heart Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, PO BOX 112412, United Arab Emirates
3
Department of Surgery, Section of Cardiac Surgery, Shiraz University of Medical Sciences, PO BOX 71348-14336, Shiraz, Iran
4
Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, PO BOX 71348-14336, Shiraz, Iran
5
Department of Perfusion, Division of Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, PO BOX 71348-14336, Shiraz, Iran
* Corresponding author: buttsab9@hotmail.com
Received:
30
January
2024
Accepted:
13
May
2024
Background: The del Nido cardioplegia solution is a widely used method for myocardial protection in various settings. However, there is limited evidence of its effectiveness in adult cardiac surgery, and the baseline solution, Plasma Lyte A, is not readily available, leading to the use of alternative baseline solutions. This study aims to investigate the effectiveness of routine del Nido cardioplegia in adult cardiac surgery and the impact of different baseline solutions on myocardial protection and other perioperative outcomes. Methods: This study was a prospective, double-blind randomized parallel group clinical trial conducted at a single tertiary care hospital in Iran. A total of 187 adult patients were evaluated for eligibility, of which 120 met the inclusion criteria for elective isolated CABG surgery. The patients were randomly assigned to three groups, with each group consisting of 40 patients. The control group received a normal saline-based routine del Nido cardioplegia, Intervention Group A received Ringer lactate-based del Nido cardioplegia, and Intervention Group B received plain Ringer-based del Nido cardioplegia. The levels of Creatine Kinase-MB (CK-MB), Troponin T, Troponin I, and lactate were primarily assessed at four different times: after anesthesia induction (Baseline), 2 h, 12 h, and 24 h. Results: Preoperative demographic and clinical characteristics were the same among groups with insignificant differences (p > 0.05). There was no significant difference among groups based on CK-MB, Troponin T, Troponin I, and lactate levels (p = 0.078, 0.143, 0.311, and 0.129 respectively). However, there was a significant difference in the time effect of Troponin T and Lactate (p = 0.034, p = <0.001). Conclusion: Normal saline, Ringer lactate, and plain Ringer provide comparable myocardial protection in adult-isolated CABG surgery with modified del Nido cardioplegia. Larger studies are needed to identify the best alternative to Plasma Lyte A while maintaining del Nido cardioplegia as the control.
Key words: Myocardial protection / Modified del Nido cardioplegia solution / Coronary artery bypass grafting (CABG) surgery
© The Author(s), published by EDP Sciences, 2024
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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