Münch F, Purbojo A, Kellermann S, Jansen C, Cesnjevar R, Rüffer A (2015)
Publication Type: Journal article
Publication year: 2015
Book Volume: 24
Pages Range: 44-48
Journal Issue: 2
Calafiore blood cardioplegia is not used in paediatric cardiac surgery at present. We propose that fewer fluctuations in the electrolyte levels occur after administration of modified Calafiore blood cardioplegia for infants and neonates, as compared with the use of Bretschneider crystalloid solution. In an experimental study, 26 piglets (average weight 11.1 ± 1.0 kg) were cardio-plegically arrested for 60 minutes during cardio pulmonary bypass (CPB). Piglets were randomised either to cold crystalloid cardioplegia (CCC) at 4 °C, or to modified “tepid“ Calafiore blood cardioplegia (MBC) at 28 °C. Fluctuations in electrolyte levels and changes in the acid-alkaline bal-ance were recorded until completion of CPB procedure; subsequently both groups were compared and evaluated. A significantly lower serum sodium level was recorded after 30 minutes of ischaemia in the CCC group (CCC: 123 ± 4 mmol/l vs. MBC: 131 ± 4 mmol/l; p < 0.001), which could not be compensated despite significantly higher substitution of sodium bi-carbonate (p = 0.019) throughout the procedure (CCC: 130 ± 5 mmol/l vs. MBC: 134 ± 5 mmol/l; p = 0.032). After 30 minutes of ischaemia the serum potassium and calcium levels were significantly higher in the MBC group than in the CCC group (potassium; CCC: 5.1 ± 0.5 mmol/l vs. MBC: 6.0 ± 4.6 mmol/l; p = 0.001 and cal-cium; CCC: 1.24 ± 0.07 mmol/l vs. MBC: 1.38 ± 0.08 mmol/l; p = 0.001). No significant differences in potassium and cal-cium levels were found between the two groups ten minutes after CPB completion (potassium; CCC: 4.7 ± 0.3 mmol/l vs. MBC: 4.7 ± 0.4 mmol/l; p = 0.398 and cal-cium; CCC: 1.13 ± 0.13 mmol/l vs. MBC: 1.18 ± 0.13 mmol/l; p = 0.235). An increase in potassium and calcium levels during aortic cross clamping after MBC administration was readily revers-ible, whereas CCC-induced prolonged hy-ponatraemia required significantly higher bicarbonate substitution.
APA:
Münch, F., Purbojo, A., Kellermann, S., Jansen, C., Cesnjevar, R., & Rüffer, A. (2015). Neue Strategien in der Kinderherzchirurgie: verminderte Elektrolytschwankungen durch modifizierte Blutkardioplegie nach Calafiore. Kardiotechnik, 24(2), 44-48.
MLA:
Münch, Frank, et al. "Neue Strategien in der Kinderherzchirurgie: verminderte Elektrolytschwankungen durch modifizierte Blutkardioplegie nach Calafiore." Kardiotechnik 24.2 (2015): 44-48.
BibTeX: Download