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Titolo:
Cold continuous antegrade blood cardioplegia: high versus low hematocrit
Autore:
Baretti, R; Mizuno, A; Buckberg, GD; Young, HH; Hetzer, R;
Indirizzi:
Univ Calif Los Angeles, Sch Med, Div Cardiothorac Surg, Los Angeles, CA USA Univ Calif Los Angeles Los Angeles CA USA orac Surg, Los Angeles, CA USA
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 5, volume: 19, anno: 2001,
pagine: 640 - 646
SICI:
1010-7940(200105)19:5<640:CCABCH>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOPULMONARY BYPASS; EXTREME HEMODILUTION; SURGERY; HEART; PROTECTION; METABOLISM; HUMANS;
Keywords:
hematocrit; cardioplegia; myocardial protection; cardiopulmonary bypass; extracorporal circulation; heart surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Baretti, R Deutsch Herzzentrum Berlin, Augustenburger Pl 1, D-13353 Berlin, Germany Deutsch Herzzentrum Berlin Augustenburger Pl 1 Berlin Germany D-13353
Citazione:
R. Baretti et al., "Cold continuous antegrade blood cardioplegia: high versus low hematocrit", EUR J CAR-T, 19(5), 2001, pp. 640-646

Abstract

Objective: Cold continuous antegrade blood cardioplegia (CCABCP) is used with different hematocrit values. We investigated the consequences of CCABCPwith low hematocrit (LH: 20-25%) versus high hematocrit (HH: 40-45%). Methods: Anesthetized open chest pigs (25 kg) were placed on cardiopulmonary bypass (CPB). The hearts were arrested for 30 min by 6 degreesC CCABCP with either LH or HH (n = 8, each): After an initial 3 min application of high potassium (20 mEq) BCP the hearts were arrested for subsequent 27 min by normokalemic 6 degreesC cold blood delivered continuously antegradely. Thereafter the hearts underwent perfusion with warm systemic blood for an additional 30 min on CPB. Biochemical cardiac data (MVO2 (ml min(-1) 100 g(-1)), release of creatine kinase (CK; units min(-1) 100 g(-1))) and lactate (mg min(-1) 100 g(-1)) and the coronary vascular resistance index (CVRI (mmHg ml(-1) min g)) were measured during CPB. Total tissue water content (%) and leftand right ventricular stroke work indices (LV-and RV-SWI (g m kg(-1))) were assessed 30 min after discontinuation of CPB and compared to pre-CPB controls. Results: The hearts of the LH group had no biochemical or functional disturbance. The HH group showed marked CK leakage (0.6 +/- 0.2*: vs. 0.1 +/- 0.1, *P < 0.05 for comparison of LH vs. HH with Student's t-test for unpaired data), impaired initial oxygen consumption (4 +/- 1* vs. 7 +/- 1) after cardiac arrest, an increased CVRI (82 +/- 12* vs. 50 +/- 8), the formation of myocardial edema (81.0 +/- 1.3* vs. 77.5 +/- 1.2), and poor functional recovery (LVSWI 0.2 +/- 0.1* vs. 1.0 +/- 0.1; RVSWI 0.1 +/- 0.1* vs. 0.5 /- 0.1). The absence of lactate production in both groups was in accord with the non-ischemic protocol. Conclusions: CCABCP with a low hematocrit of 20-25% is cardioprotective. In contrast, CCABCP with a high hematocrit of 40-45% jeopardizes the heart despite avoiding ischemic periods, and should be avoided. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 10:17:52