<原著>新生仔家兎心筋に対するcrystalloidおよびcold blood cardioplegiaの投与頻度と心筋保護効果の検討
スポンサーリンク
概要
- 論文の詳細を見る
Inadequate preservation of immature myocardium during global ischemia remains a significant clinical problem. But the protective effects of cold blood cardioplegia (CBC) has not been examinated with immature myocardium. In the present study, the efficacy of crystalloid cardioplegia (St. Thomas' Hospital solution : ST) and CBC in the neonatal heart were investigated to determine whether the responses to frequent administration of each cardioplegic solution would be the same. Isolated neonatal rabbit hearts (6 to 9 days of age) were subjected to 3 hours of ischemia at 15℃, and treated with ST or CBC. Each solution was administrated in a single-dose (ST-single, CBC-single), or multiple-doses every 60 (ST-60,CBC-60), 30 (ST-30,CBC-30), and 15 minutes (ST-15,CBC-15) during ischemia. Highenergy phosphate levels were measured at the end of ischemia and during reperfusion by 31-phosphorus nuclear magnetic resonance spectroscopy in each group (n=5). Myocardial water content was also measured at the end of ischemia. At the end of ischemia, the level of adenosine triphosphate (ATP, percent of preischemic control value) in ST-single (74.3±4.5%) and ST-60 (82.6±6.5%) were higher than in ST-30 (68.5±6.8%) and ST-15 (59.9±6.3%) (p<0.05 : ST-60 vs ST-15). After 30 minutes of reperfusion, recovery of the ATP level in ST-single (91.7±2.6%) and ST-60 (88.2±2.3%) were significantly higher than in ST-30 (72.5±7.2%) and ST-15 (63.1±5.0%) (p<0.05). Conversely, in the CBC groups, the ATP level in CBC-15 (85.0±4.0%) was significantly higher than in CBC-60 (64.6±4.8%), and CBC-single (60.3±3.9%), at end ischemia (p<0.05), and recovery of the ATP level was best in CBC-15 (95.1±3.6%) (p<0.05). Myocardial water content was significantly higher in the ST group than in the CBC group. However no significant difference was noted among the subgroups of the ST group. The lack of free radical scavenger, not the lack of oncotic pressure, in ST might have caused the deterious effect of frequent infusion of ST in the neonatal heart. Conclusion : In multi-dose administration of cardioplegia, ST showed detrimental effects ; in contrast, CBC had beneficial effects on preservation and recovery of the ATP level, in the neonatal heart. CBC maintained myocardial water content within the physiological level. In conclusion, CBC is recommended for neonates in clinical practice.
- 近畿大学の論文
- 1993-09-25
著者
関連論文
- DP-034-3 軽度低体温循環停止下選択的順行性脳還流法を用いた胸部大動脈手術の検討(第107回日本外科学会定期学術集会)
- 新しい人工血管(UBE woven graft 150cc WYK type)の使用経験 : シールドグラフトとの比較・検討
- 人工心肺を用いた開心術および大血管手術後の深部感染に対する治療
- 心移植ドナーモデルに対するエンドセリン受容体拮抗薬TAK-044のpretreatment効果
- 小児に対する経静脈的ペースメーカーの植え込み
- 15.最近5年間の腹部動脈瘤手術経験
- C50 右心系再建補填材としての有茎自己心膜使用の経験(心臓(3))
- C44 Modified UltrafiltrationのVSD術後の心肺機能に及ぼす影響(心臓(2))
- 0506 冠動脈バイパス術におけるpreconditionig効果 : ATP感受性カリウムチャネル開口薬の心筋保護作用
- P-823 80歳以上の高齢者に対する冠動脈バイパス術の検討