Minimally-Diluted Blood Cardioplegia Supplemented With Potassium and Magnesium for Combination of 'Initial, Continuous and Intermittent Bolus' Administration

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• Background The present study was designed to examine the hypothesis that minimally-diluted blood cardioplegia (BCP) supplemented with potassium and magnesium provides superior myocardial protection in comparison with the standard-diluted BCP for a combination of 'initial, continuous, and intermittent bolus' BCP administration. Methods and Results Seventy patients undergoing elective coronary revascularization between 1997 and 2001 (M:F=55:15, mean age 67.6±7.5 years) were randomly divided into 2 groups: Group C (n=35) was given the standard 4:1-diluted blood-crystalloid BCP, and Group M (n=35) was given minimally-diluted BCP supplemented with potassium-chloride and magnesium-sulfate. The BCP temperature was maintained at 30℃. Cardioplegic arrest was induced with 2 min of initial antegrade BCP infusion, followed by continuous retrograde BCP infusion. Intermittent antegrade BCP was infused every 30 min for 2 min. The time required for achieving cardioplegic arrest was significantly shorter in Group M (47.5±16.3 vs 62.5±17.6 s, p<0.0001). The number of patients showing spontaneous heart beat recovery after reperfusion was significantly larger in Group M (28 vs 15, p=0.0029), and the number of patients suffering from atrial fibrillation during the postoperative period was significantly smaller in Group M (n=3 vs 11, p=0.034). Both the postoperative maximum dopamine dose (3.57±2.46 vs 5.44±2.23μg/kg per min, p=0.0014) and peak creatine kinase-MB (19.5±8.5 vs 25.8±11.9IU/L, p=0.0128) were significantly less in Group M. The number of patients showing paradoxical movement of the ventricular septum in the early postoperative echocardiography was significantly smaller in Group M (9 vs 24 p=0.0007). Conclusions These results suggest that 'initial, continuous and intermittent bolus' administration of minimallydiluted BCP supplemented with potassium and magnesium is a reliable and effective technique for intraoperative myocardial protection.

• 社団法人日本循環器学会の論文
• 2004-04-20

著者

• Sawa Yoshiki

  Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine

• Horio Masaru

  Ehime University

• Matsuda H

  Department Of Cardiovascular Surgery Hyogo Medical College

• Sawa Yoshiki

  Department Of Cardiovascular Surgery Osaka Graduate School Of Medicine

• Matsuda Hikaru

  Department Of Internal Medicine And Therapeutics Osaka University Graduate School Of Medicine

• Yoshikawa H

  Division Of Cardiovascular Surgery Orthopedics Osaka University Graduate School Of Medicine

• Kawashima Yasunaru

  Division Of Cardiovascular Surgery Osaka Minami National Hospital

• Kawashima Yasunaru

  大阪大学 第1外科

• Hayashi Yoshitaka

  Division Of Cardiovascular Surgery Orthopedics Osaka University Graduate School Of Medicine

• Matsuo Hirohide

  Division Of Cardiovascular Surgery Cardiovascular Medicine Osaka University Graduate School Of Medic

• Ohtani Masakatsu

  Division of Cardiac Surgery, Sakurabashi Watanabe Hospital

• Kawashima Yasunaru

  First Department Of Surgery Osaka University Medical School

• Hiraishi Taizo

  Division Of Cardiovascular Surgery Osaka Minami National Hospital

• Matsuda Hikaru

  Division Of Cardiovascular Surgery Cardiovascular Medicine Osaka University Graduate School Of Medic

• KAWASHIMA YASUNARI

  FIRST DEPARTMENT OF SURGERY OSAKA UNIVERSITY MEDICAL SCHOOL

• Ohtani Masakatsu

  Division Of Cardiac Surgery Sakurabashi Watanabe Hospital:first Department Of Surgery Osaka Universi

• Kawashima Yasunaru

  First Department Of Surgery And Department Of Physiological Chemistry Osaka University Medical Schoo

• Matsuda Hikaru

  Department Of Cardiology Osaka University Graduate School Of Medicine

• Kobayashi Yasuhiko

  Division Of Cardiovascular Surgery Osaka Minami National Hospital

• Akedo Hiroshi

  Division of Cardiovascular Surgery, Osaka Minami National Hospital

• Yoshikawa H

  Department Of Orthopedic Surgery Osaka University School Of Medicine

• Matsuda Hikaru

  Department Of Cardiology Ehime Prefectural Imabari Hospital

• Horio Masaru

  Division Of Health Sciences Department Of Functional Diagnostic Science Osaka University Graduate Sc

• Hori Masatsugu

  Department Of Cardiology Ehime Prefectural Imabari Hospital

• Akedo Hiroshi

  Division Of Cardiovascular Surgery Osaka Minami National Hospital

• Kobayashi Yasuhiko

  Division Of Cardiology National Hospital Organization Osaka National Hospital

• Kawashima Yasunaru

  1st Department Of Surgery Osaka University Medical School

• Matsuda Hikaru

  Department Of Integrated Medicine Kagawa University

• Sawa Yoshiki

  Department Of Cardiovascular Medicine Osaka University Graduate School Of Medicine

• Hayashi Yoshitaka

  Division Of Cardiology Department Of Internal Medicine Juntendo University School Of Medicine

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