Comparison of lactated Ringer's solution and Plasma-Lyte A as a base solution for del Nido cardioplegia: a prospective randomized trial
Abstract OBJECTIVES The use of del Nido cardioplegia has been increasing in popularity for adult cardiac surgery. However, the base solution, Plasma-Lyte A, is not always available in many countries. This prospective randomized controlled trial evaluated myocardial preservation and clinical outcomes...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2024-03, Vol.65 (3) |
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| container_title | European journal of cardio-thoracic surgery |
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| creator | Kantathut, Narongrit Krathong, Pimchanok Khajarern, Siam Leelayana, Parinya Cherntanomwong, Piya |
| description | Abstract
OBJECTIVES
The use of del Nido cardioplegia has been increasing in popularity for adult cardiac surgery. However, the base solution, Plasma-Lyte A, is not always available in many countries. This prospective randomized controlled trial evaluated myocardial preservation and clinical outcomes when using lactated Ringer's solution (LRS) compared to Plasma-Lyte A as a base solution for del Nido cardioplegia.
METHODS
Adult patients undergoing first-time elective cardiac surgery for acquired heart disease, including isolated coronary artery bypass grafting, isolated valve surgery, combined valve surgery or concomitant coronary artery bypass grafting and valve surgery were randomized to receive either LRS (n = 100) or Plasma-Lyte A (n = 100).
RESULTS
There were no significant differences between the 2 groups in terms of age, comorbidities, Society of Thoracic Surgeons risk score and type of procedures. The primary outcome, postoperative troponin-T at 24 h, was similar in both groups (0.482 vs 0.524 ng/ml; P = 0.464). Other cardiac markers were also similar at all time points. The LRS group had a lower pH (7.228 vs 7.246; P = 0.005) and higher calcium levels (0.908 vs 0.358 mmol/l; P |
| doi_str_mv | 10.1093/ejcts/ezae018 |
| format | Article |
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OBJECTIVES
The use of del Nido cardioplegia has been increasing in popularity for adult cardiac surgery. However, the base solution, Plasma-Lyte A, is not always available in many countries. This prospective randomized controlled trial evaluated myocardial preservation and clinical outcomes when using lactated Ringer's solution (LRS) compared to Plasma-Lyte A as a base solution for del Nido cardioplegia.
METHODS
Adult patients undergoing first-time elective cardiac surgery for acquired heart disease, including isolated coronary artery bypass grafting, isolated valve surgery, combined valve surgery or concomitant coronary artery bypass grafting and valve surgery were randomized to receive either LRS (n = 100) or Plasma-Lyte A (n = 100).
RESULTS
There were no significant differences between the 2 groups in terms of age, comorbidities, Society of Thoracic Surgeons risk score and type of procedures. The primary outcome, postoperative troponin-T at 24 h, was similar in both groups (0.482 vs 0.524 ng/ml; P = 0.464). Other cardiac markers were also similar at all time points. The LRS group had a lower pH (7.228 vs 7.246; P = 0.005) and higher calcium levels (0.908 vs 0.358 mmol/l; P < 0.001) in the delivered cardioplegia, but there were no significant differences in clinical outcomes, such as ventricular fibrillation, left ventricular ejection fraction, inotrope/vasopressor requirement, intra-aortic balloon pump support, intensive care unit stay, hospital stay, atrial fibrillation, red cell transfusion and complications.
CONCLUSIONS
The results suggest that LRS can be used as an alternative to Plasma-Lyte A as the base solution for del Nido cardioplegia, with similar myocardial preservation and clinical outcomes.
Effective myocardial preservation is essential to ensure optimal patient outcomes in cardiac surgery.</description><identifier>ISSN: 1873-734X</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1093/ejcts/ezae018</identifier><identifier>PMID: 38244592</identifier><language>eng</language><publisher>Germany: Oxford University Press</publisher><subject>Adult ; Cardioplegic Solutions - therapeutic use ; Electrolytes ; Heart Arrest, Induced - methods ; Humans ; Prospective Studies ; Retrospective Studies ; Ringer's Lactate ; Stroke Volume ; Ventricular Function, Left</subject><ispartof>European journal of cardio-thoracic surgery, 2024-03, Vol.65 (3)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c326t-495253bce74dab669612659d17425d50ec20a0b77e67a32ba83449c8206b85ae3</citedby><cites>FETCH-LOGICAL-c326t-495253bce74dab669612659d17425d50ec20a0b77e67a32ba83449c8206b85ae3</cites><orcidid>0000-0003-1166-1384</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38244592$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kantathut, Narongrit</creatorcontrib><creatorcontrib>Krathong, Pimchanok</creatorcontrib><creatorcontrib>Khajarern, Siam</creatorcontrib><creatorcontrib>Leelayana, Parinya</creatorcontrib><creatorcontrib>Cherntanomwong, Piya</creatorcontrib><title>Comparison of lactated Ringer's solution and Plasma-Lyte A as a base solution for del Nido cardioplegia: a prospective randomized trial</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><description>Abstract
OBJECTIVES
The use of del Nido cardioplegia has been increasing in popularity for adult cardiac surgery. However, the base solution, Plasma-Lyte A, is not always available in many countries. This prospective randomized controlled trial evaluated myocardial preservation and clinical outcomes when using lactated Ringer's solution (LRS) compared to Plasma-Lyte A as a base solution for del Nido cardioplegia.
METHODS
Adult patients undergoing first-time elective cardiac surgery for acquired heart disease, including isolated coronary artery bypass grafting, isolated valve surgery, combined valve surgery or concomitant coronary artery bypass grafting and valve surgery were randomized to receive either LRS (n = 100) or Plasma-Lyte A (n = 100).
RESULTS
There were no significant differences between the 2 groups in terms of age, comorbidities, Society of Thoracic Surgeons risk score and type of procedures. The primary outcome, postoperative troponin-T at 24 h, was similar in both groups (0.482 vs 0.524 ng/ml; P = 0.464). Other cardiac markers were also similar at all time points. The LRS group had a lower pH (7.228 vs 7.246; P = 0.005) and higher calcium levels (0.908 vs 0.358 mmol/l; P < 0.001) in the delivered cardioplegia, but there were no significant differences in clinical outcomes, such as ventricular fibrillation, left ventricular ejection fraction, inotrope/vasopressor requirement, intra-aortic balloon pump support, intensive care unit stay, hospital stay, atrial fibrillation, red cell transfusion and complications.
CONCLUSIONS
The results suggest that LRS can be used as an alternative to Plasma-Lyte A as the base solution for del Nido cardioplegia, with similar myocardial preservation and clinical outcomes.
Effective myocardial preservation is essential to ensure optimal patient outcomes in cardiac surgery.</description><subject>Adult</subject><subject>Cardioplegic Solutions - therapeutic use</subject><subject>Electrolytes</subject><subject>Heart Arrest, Induced - methods</subject><subject>Humans</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Ringer's Lactate</subject><subject>Stroke Volume</subject><subject>Ventricular Function, Left</subject><issn>1873-734X</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkMtKxTAQhoMo3pduJTvdVNMkTVt3cvAGBxVRcFemyRyJpCc1SQV9AV_bqsfLztUMzMf_Dx8hOzk7yFktDvFRp3iIr4Asr5bIel6VIiuFvF_-s6-RjRgfGWNK8HKVrImKS1nUfJ28TXzXQ7DRz6mfUQc6QUJDb-z8AcNepNG7IdnxCnNDrx3EDrLpS0J6TCFSoC1E_IVmPlCDjl5a46mGYKzvHT5YOBrRPvjYo072GWkY43xnX8eqFCy4LbIyAxdxezE3yd3pye3kPJtenV1MjqeZFlylTNYFL0SrsZQGWqVqlXNV1CYvJS9MwVBzBqwtS1QlCN5CJaSsdcWZaqsCUGyS_a_c8ZmnAWNqOhs1Ogdz9ENseM1rphiT-YhmX6ge_44BZ00fbAfhpclZ8-G--XTfLNyP_O4iemg7ND_0t-zfbj_0_2S9A1eDkKk</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Kantathut, Narongrit</creator><creator>Krathong, Pimchanok</creator><creator>Khajarern, Siam</creator><creator>Leelayana, Parinya</creator><creator>Cherntanomwong, Piya</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1166-1384</orcidid></search><sort><creationdate>20240301</creationdate><title>Comparison of lactated Ringer's solution and Plasma-Lyte A as a base solution for del Nido cardioplegia: a prospective randomized trial</title><author>Kantathut, Narongrit ; Krathong, Pimchanok ; Khajarern, Siam ; Leelayana, Parinya ; Cherntanomwong, Piya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-495253bce74dab669612659d17425d50ec20a0b77e67a32ba83449c8206b85ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Cardioplegic Solutions - therapeutic use</topic><topic>Electrolytes</topic><topic>Heart Arrest, Induced - methods</topic><topic>Humans</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Ringer's Lactate</topic><topic>Stroke Volume</topic><topic>Ventricular Function, Left</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kantathut, Narongrit</creatorcontrib><creatorcontrib>Krathong, Pimchanok</creatorcontrib><creatorcontrib>Khajarern, Siam</creatorcontrib><creatorcontrib>Leelayana, Parinya</creatorcontrib><creatorcontrib>Cherntanomwong, Piya</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kantathut, Narongrit</au><au>Krathong, Pimchanok</au><au>Khajarern, Siam</au><au>Leelayana, Parinya</au><au>Cherntanomwong, Piya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of lactated Ringer's solution and Plasma-Lyte A as a base solution for del Nido cardioplegia: a prospective randomized trial</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>65</volume><issue>3</issue><issn>1873-734X</issn><eissn>1873-734X</eissn><abstract>Abstract
OBJECTIVES
The use of del Nido cardioplegia has been increasing in popularity for adult cardiac surgery. However, the base solution, Plasma-Lyte A, is not always available in many countries. This prospective randomized controlled trial evaluated myocardial preservation and clinical outcomes when using lactated Ringer's solution (LRS) compared to Plasma-Lyte A as a base solution for del Nido cardioplegia.
METHODS
Adult patients undergoing first-time elective cardiac surgery for acquired heart disease, including isolated coronary artery bypass grafting, isolated valve surgery, combined valve surgery or concomitant coronary artery bypass grafting and valve surgery were randomized to receive either LRS (n = 100) or Plasma-Lyte A (n = 100).
RESULTS
There were no significant differences between the 2 groups in terms of age, comorbidities, Society of Thoracic Surgeons risk score and type of procedures. The primary outcome, postoperative troponin-T at 24 h, was similar in both groups (0.482 vs 0.524 ng/ml; P = 0.464). Other cardiac markers were also similar at all time points. The LRS group had a lower pH (7.228 vs 7.246; P = 0.005) and higher calcium levels (0.908 vs 0.358 mmol/l; P < 0.001) in the delivered cardioplegia, but there were no significant differences in clinical outcomes, such as ventricular fibrillation, left ventricular ejection fraction, inotrope/vasopressor requirement, intra-aortic balloon pump support, intensive care unit stay, hospital stay, atrial fibrillation, red cell transfusion and complications.
CONCLUSIONS
The results suggest that LRS can be used as an alternative to Plasma-Lyte A as the base solution for del Nido cardioplegia, with similar myocardial preservation and clinical outcomes.
Effective myocardial preservation is essential to ensure optimal patient outcomes in cardiac surgery.</abstract><cop>Germany</cop><pub>Oxford University Press</pub><pmid>38244592</pmid><doi>10.1093/ejcts/ezae018</doi><orcidid>https://orcid.org/0000-0003-1166-1384</orcidid></addata></record> |
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| ispartof | European journal of cardio-thoracic surgery, 2024-03, Vol.65 (3) |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current) |
| subjects | Adult Cardioplegic Solutions - therapeutic use Electrolytes Heart Arrest, Induced - methods Humans Prospective Studies Retrospective Studies Ringer's Lactate Stroke Volume Ventricular Function, Left |
| title | Comparison of lactated Ringer's solution and Plasma-Lyte A as a base solution for del Nido cardioplegia: a prospective randomized trial |
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