Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG
Background. This study evaluated the myocardial protective strategies in isolated coronary bypass surgeries. Methods. One hundred and twenty-eight patients were prospectively randomized to 3 techniques of myocardial protection; group I (n = 47) antegrade/retrograde tepid blood cardioplegia, group II...
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| Veröffentlicht in: | The Annals of thoracic surgery 1999-08, Vol.68 (2), p.447-453 |
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| container_title | The Annals of thoracic surgery |
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| creator | Elwatidy, Ahmed M.F Fadalah, Mohsen A Bukhari, Emad A Aljubair, Khalid A Syed, Aitizazuddin Ashmeg, Abullah K Alfagih, Mohamed R |
| description | Background. This study evaluated the myocardial protective strategies in isolated coronary bypass surgeries.
Methods. One hundred and twenty-eight patients were prospectively randomized to 3 techniques of myocardial protection; group I (n = 47) antegrade/retrograde tepid blood cardioplegia, group II (n = 40) antegrade/retrograde cold blood cardioplegia with topical cooling, group III (n = 41) antegrade crystalloid cardioplegia with topical cooling.
Results. The incidence of spontaneous defibrillation was significantly higher in group I (
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| doi_str_mv | 10.1016/S0003-4975(99)00359-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70010139</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0003497599003598</els_id><sourcerecordid>70010139</sourcerecordid><originalsourceid>FETCH-LOGICAL-c425t-d1bd92e035337506689d74358dfd56cffe9e8fed4347119ccd87dee3232102753</originalsourceid><addsrcrecordid>eNqFkE1PAyEQhonRaP34CZo9GKOHVViW3eVkauNX0sSDeiaUmTUYulTYmvTfS239iBdPQOZ5mZmHkENGzxll1cUjpZTnpazFqZRn6S5k3myQAROiyKtCyE0y-EZ2yG6Mr-lZpPI22WG0rEXJ2IDAsOvxJWjAzIRF7LVz3kJmdADrZw5frM7eY6a_qIuAffDrgHeQKpD1OEuZifP-T9J22Wh4dbtPtlrtIh6szz3yfHP9NLrLxw-396PhODdlIfoc2ARkgWkVzmtBq6qRUJdcNNCCqEzbosSmRSh5WTMmjYGmBkRe8ILRohZ8j5ys_p0F_zbH2KupjQad0x36eVQ1pckdlwkUK9AEH2PAVs2CneqwUIyqpV71qVct3Skp1ade1aTc0brBfDJF-JVa-UzA8RrQ0WjXBt0ZG384yas0Z8IuVxgmG-8Wg4rGYmcQbEDTK_D2n0k-APs_luc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70010139</pqid></control><display><type>article</type><title>Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Elwatidy, Ahmed M.F ; Fadalah, Mohsen A ; Bukhari, Emad A ; Aljubair, Khalid A ; Syed, Aitizazuddin ; Ashmeg, Abullah K ; Alfagih, Mohamed R</creator><creatorcontrib>Elwatidy, Ahmed M.F ; Fadalah, Mohsen A ; Bukhari, Emad A ; Aljubair, Khalid A ; Syed, Aitizazuddin ; Ashmeg, Abullah K ; Alfagih, Mohamed R</creatorcontrib><description>Background. This study evaluated the myocardial protective strategies in isolated coronary bypass surgeries.
Methods. One hundred and twenty-eight patients were prospectively randomized to 3 techniques of myocardial protection; group I (n = 47) antegrade/retrograde tepid blood cardioplegia, group II (n = 40) antegrade/retrograde cold blood cardioplegia with topical cooling, group III (n = 41) antegrade crystalloid cardioplegia with topical cooling.
Results. The incidence of spontaneous defibrillation was significantly higher in group I (
p <0.001) while the incidence of low cardiac output was not different between the 3 groups. The incidence of ventricular arrhythmia was higher in group III (
p <0.016 group III vs I). There was no significant statistical difference in hemodynamic recovery between the 3 groups. CK-MB levels were significantly lower in group I versus the other 2 groups, (
p= 0.0013, 0.04). Acid release and oxygen extraction were higher in group II than in group I (
p= 0.06) during cardioplegia and reperfusion. Lactate release was less in group I at the release of aortic cross-clamp, and reperfusion. There was no significant difference between the 3 groups in ICU stay, ventilation time, or hospital complications.
Conclusions. Tepid blood cardioplegia showed superiority in metabolic and functional recovery, whereas crystalloid cardioplegia had the highest incidence of postoperative arrhythmias. There was no significant statistical difference between the 3 groups in hospital mortality and morbidity.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/S0003-4975(99)00359-8</identifier><identifier>PMID: 10475411</identifier><identifier>CODEN: ATHSAK</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Anesthesia ; Anesthesia depending on type of surgery ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac Output, Low - etiology ; Cardioplegic Solutions - administration & dosage ; Coronary Artery Bypass - methods ; Female ; Heart Arrest, Induced - methods ; Hemodynamics - physiology ; Humans ; Hypothermia, Induced - methods ; Length of Stay ; Male ; Medical sciences ; Middle Aged ; Myocardial Reperfusion Injury - etiology ; Postoperative Complications - etiology ; Prospective Studies ; Risk Factors ; Temperature ; Thoracic and cardiovascular surgery. Cardiopulmonary bypass ; Ventricular Fibrillation - etiology</subject><ispartof>The Annals of thoracic surgery, 1999-08, Vol.68 (2), p.447-453</ispartof><rights>1999 The Society of Thoracic Surgeons</rights><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c425t-d1bd92e035337506689d74358dfd56cffe9e8fed4347119ccd87dee3232102753</citedby><cites>FETCH-LOGICAL-c425t-d1bd92e035337506689d74358dfd56cffe9e8fed4347119ccd87dee3232102753</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003497599003598$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1936753$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10475411$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elwatidy, Ahmed M.F</creatorcontrib><creatorcontrib>Fadalah, Mohsen A</creatorcontrib><creatorcontrib>Bukhari, Emad A</creatorcontrib><creatorcontrib>Aljubair, Khalid A</creatorcontrib><creatorcontrib>Syed, Aitizazuddin</creatorcontrib><creatorcontrib>Ashmeg, Abullah K</creatorcontrib><creatorcontrib>Alfagih, Mohamed R</creatorcontrib><title>Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Background. This study evaluated the myocardial protective strategies in isolated coronary bypass surgeries.
Methods. One hundred and twenty-eight patients were prospectively randomized to 3 techniques of myocardial protection; group I (n = 47) antegrade/retrograde tepid blood cardioplegia, group II (n = 40) antegrade/retrograde cold blood cardioplegia with topical cooling, group III (n = 41) antegrade crystalloid cardioplegia with topical cooling.
Results. The incidence of spontaneous defibrillation was significantly higher in group I (
p <0.001) while the incidence of low cardiac output was not different between the 3 groups. The incidence of ventricular arrhythmia was higher in group III (
p <0.016 group III vs I). There was no significant statistical difference in hemodynamic recovery between the 3 groups. CK-MB levels were significantly lower in group I versus the other 2 groups, (
p= 0.0013, 0.04). Acid release and oxygen extraction were higher in group II than in group I (
p= 0.06) during cardioplegia and reperfusion. Lactate release was less in group I at the release of aortic cross-clamp, and reperfusion. There was no significant difference between the 3 groups in ICU stay, ventilation time, or hospital complications.
Conclusions. Tepid blood cardioplegia showed superiority in metabolic and functional recovery, whereas crystalloid cardioplegia had the highest incidence of postoperative arrhythmias. There was no significant statistical difference between the 3 groups in hospital mortality and morbidity.</description><subject>Adult</subject><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia depending on type of surgery</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Cardiac Output, Low - etiology</subject><subject>Cardioplegic Solutions - administration & dosage</subject><subject>Coronary Artery Bypass - methods</subject><subject>Female</subject><subject>Heart Arrest, Induced - methods</subject><subject>Hemodynamics - physiology</subject><subject>Humans</subject><subject>Hypothermia, Induced - methods</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Reperfusion Injury - etiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Temperature</subject><subject>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</subject><subject>Ventricular Fibrillation - etiology</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1PAyEQhonRaP34CZo9GKOHVViW3eVkauNX0sSDeiaUmTUYulTYmvTfS239iBdPQOZ5mZmHkENGzxll1cUjpZTnpazFqZRn6S5k3myQAROiyKtCyE0y-EZ2yG6Mr-lZpPI22WG0rEXJ2IDAsOvxJWjAzIRF7LVz3kJmdADrZw5frM7eY6a_qIuAffDrgHeQKpD1OEuZifP-T9J22Wh4dbtPtlrtIh6szz3yfHP9NLrLxw-396PhODdlIfoc2ARkgWkVzmtBq6qRUJdcNNCCqEzbosSmRSh5WTMmjYGmBkRe8ILRohZ8j5ys_p0F_zbH2KupjQad0x36eVQ1pckdlwkUK9AEH2PAVs2CneqwUIyqpV71qVct3Skp1ade1aTc0brBfDJF-JVa-UzA8RrQ0WjXBt0ZG384yas0Z8IuVxgmG-8Wg4rGYmcQbEDTK_D2n0k-APs_luc</recordid><startdate>19990801</startdate><enddate>19990801</enddate><creator>Elwatidy, Ahmed M.F</creator><creator>Fadalah, Mohsen A</creator><creator>Bukhari, Emad A</creator><creator>Aljubair, Khalid A</creator><creator>Syed, Aitizazuddin</creator><creator>Ashmeg, Abullah K</creator><creator>Alfagih, Mohamed R</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><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></search><sort><creationdate>19990801</creationdate><title>Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG</title><author>Elwatidy, Ahmed M.F ; Fadalah, Mohsen A ; Bukhari, Emad A ; Aljubair, Khalid A ; Syed, Aitizazuddin ; Ashmeg, Abullah K ; Alfagih, Mohamed R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c425t-d1bd92e035337506689d74358dfd56cffe9e8fed4347119ccd87dee3232102753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia depending on type of surgery</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Cardiac Output, Low - etiology</topic><topic>Cardioplegic Solutions - administration & dosage</topic><topic>Coronary Artery Bypass - methods</topic><topic>Female</topic><topic>Heart Arrest, Induced - methods</topic><topic>Hemodynamics - physiology</topic><topic>Humans</topic><topic>Hypothermia, Induced - methods</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Reperfusion Injury - etiology</topic><topic>Postoperative Complications - etiology</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Temperature</topic><topic>Thoracic and cardiovascular surgery. Cardiopulmonary bypass</topic><topic>Ventricular Fibrillation - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elwatidy, Ahmed M.F</creatorcontrib><creatorcontrib>Fadalah, Mohsen A</creatorcontrib><creatorcontrib>Bukhari, Emad A</creatorcontrib><creatorcontrib>Aljubair, Khalid A</creatorcontrib><creatorcontrib>Syed, Aitizazuddin</creatorcontrib><creatorcontrib>Ashmeg, Abullah K</creatorcontrib><creatorcontrib>Alfagih, Mohamed R</creatorcontrib><collection>Pascal-Francis</collection><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>The Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elwatidy, Ahmed M.F</au><au>Fadalah, Mohsen A</au><au>Bukhari, Emad A</au><au>Aljubair, Khalid A</au><au>Syed, Aitizazuddin</au><au>Ashmeg, Abullah K</au><au>Alfagih, Mohamed R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1999-08-01</date><risdate>1999</risdate><volume>68</volume><issue>2</issue><spage>447</spage><epage>453</epage><pages>447-453</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><coden>ATHSAK</coden><abstract>Background. This study evaluated the myocardial protective strategies in isolated coronary bypass surgeries.
Methods. One hundred and twenty-eight patients were prospectively randomized to 3 techniques of myocardial protection; group I (n = 47) antegrade/retrograde tepid blood cardioplegia, group II (n = 40) antegrade/retrograde cold blood cardioplegia with topical cooling, group III (n = 41) antegrade crystalloid cardioplegia with topical cooling.
Results. The incidence of spontaneous defibrillation was significantly higher in group I (
p <0.001) while the incidence of low cardiac output was not different between the 3 groups. The incidence of ventricular arrhythmia was higher in group III (
p <0.016 group III vs I). There was no significant statistical difference in hemodynamic recovery between the 3 groups. CK-MB levels were significantly lower in group I versus the other 2 groups, (
p= 0.0013, 0.04). Acid release and oxygen extraction were higher in group II than in group I (
p= 0.06) during cardioplegia and reperfusion. Lactate release was less in group I at the release of aortic cross-clamp, and reperfusion. There was no significant difference between the 3 groups in ICU stay, ventilation time, or hospital complications.
Conclusions. Tepid blood cardioplegia showed superiority in metabolic and functional recovery, whereas crystalloid cardioplegia had the highest incidence of postoperative arrhythmias. There was no significant statistical difference between the 3 groups in hospital mortality and morbidity.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10475411</pmid><doi>10.1016/S0003-4975(99)00359-8</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Anesthesia Anesthesia depending on type of surgery Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Output, Low - etiology Cardioplegic Solutions - administration & dosage Coronary Artery Bypass - methods Female Heart Arrest, Induced - methods Hemodynamics - physiology Humans Hypothermia, Induced - methods Length of Stay Male Medical sciences Middle Aged Myocardial Reperfusion Injury - etiology Postoperative Complications - etiology Prospective Studies Risk Factors Temperature Thoracic and cardiovascular surgery. Cardiopulmonary bypass Ventricular Fibrillation - etiology |
| title | Antegrade crystalloid cardioplegia vs antegrade/retrograde cold and tepid blood cardioplegia in CABG |
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