Cold Blood as the Vehicle for Potassium Cardioplegia

Barner, Hendrick B.; Laks, Hillel; Codd, John E.; Standeven, John; Jellinek, Max; Kaiser, George C.; Menz, Leo J.; Tyras, Denis H.; Pennington, D. Glenn; Hahn, John W.; Willman, Vallee L.

doi:10.1016/s0003-4975(10)63171-2

Cited by 70 publications

(6 citation statements)

References 16 publications

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“…Our data demonstrate the high efficacy of the multi dose potassium blood cardioplegia. This is in agreement with experimental and clinical observations of other authors [1,[3][4][5]7],…”

Section: Discussionsupporting

confidence: 93%

Modified Perfusion and Loading Technique of the Isolated Canine Heart

Portnoy¹,

Dwortsin²,

Machulin³

1982

Eur Surg Res

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The technique of donor perfusion of the isolated canine heart is described. It is carried out with the aid of a specially developed system providing both retrograde resuscitational coronary perfusion of the heart which sustained ischemia and perfusion with functional volume-systolic loadings of the left ventricle of the working heart under nearly physiologic conditions. This technique was used in the first group of experiments (control) to study the performance of the heart which did not sustain ischemia, and in two groups of experiments with cardioplegia. In the experiments of group II the corrected autologous blood which served as perfusate had the following composition: Hb 8.3 g%; K⁺ 2.4 mEq/1; pH 7.7; osmolarity 307 mosm/1; pO₂ 250–450 mm Hg; temperature 13–15 °C. The hearts were preserved for 2 h following single-dose perfusion. In the experiments of group III the corrected autologous blood had the following composition: Hb 8 g%; K⁺ 20–25 mEq/1; pH7.7; osmolarity 320 mosm/1; pO₂ 300–500 mm Hg; temperature 13–15 ° C. Coronary perfusion was carried out every 20 min during the 2-hour preservation period. The studies of coronary hemodynamics and cardiac function using the developed system showed practically identical results in groups I and III. In group II deep depression of myocardial function due to ischemic injury was found. The presented data on a comparative assessment of cardiac function in three groups of experiments demonstrate the high value of the developed technique of perfusion and functional loading of the myocardium.

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“…Our data demonstrate the high efficacy of the multi dose potassium blood cardioplegia. This is in agreement with experimental and clinical observations of other authors [1,[3][4][5]7],…”

Section: Discussionsupporting

confidence: 93%

Modified Perfusion and Loading Technique of the Isolated Canine Heart

Portnoy¹,

Dwortsin²,

Machulin³

1982

Eur Surg Res

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“…There were further small increases at 5 min, 30 min, and 10 hr after bypass. No significant differences between'the groups with regard to these determinations were found (figure 9).…”

Section: Resultsmentioning

confidence: 83%

A randomized comparison of crystalloid and blood-containing cardioplegic solutions in 60 patients.

Buttner¹,

Karp²,

Rêves³

et al. 1984

Circulation

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To determine whether adding blood to a cardioplegic solution affects myocardial preservation, a randomized prospective study was carried out in 60 patients undergoing coronary revascularization to compare the effects of crystalloid potassium cardioplegics (group C) and potassium cardioplegic solutions to which blood has been added ( 973-982, 1984. ALTHOUGH blood-containing cardioplegic solutions have been shown to provide adequate myocardial protection during periods of aortic occlusion,'-' their use in preference to blood-free crystalloid solutions is still controversial. The inclusion of blood in cardioplegic solutions was devised as a means to enhance their myocardial protective characteristics, mainly through increased oxygen-carrying capacity. However, the value of blood as a means of delivery of oxygen to the myocardium has been questioned.9-'' The benefit of blood as a constituent of the cardioplegic solution may vary depending on the temperature and method of administration.3' 10 To explore whether addition of blood to a cardioplegic solution could affect myocardial preservation, a randomized prospective study was conducted to compare the effects of blood-free crystalloid and blood-containing cardioplegic solutions on markers of myocardial metabolism, myocardial damage, MethodsSixty patients scheduled for elective coronary artery revascularization were studied in a protocol approved by the institutional review board of the University of Alabama in Birmingham.They were assigned to receive either a blood-containing (group B, n = 31) or a clear crystalloid (

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“…This is despite an ever-increasing aging population with increasing risk factors [ 15,16]. Since both hypothermia and pharmacologic arrest of the heart are designed to reduce myocardial oxygen demand, it seemed natural to add oxygen-carrying capacity by employing blood as the vehicle for hypothermic potassium arrest of the heart [17][18][19]. Daggett et al [19] showed that the addition of even a small amount of red blood cells to a perfusion solution could result in less myocardial edema and improved ventricular performance in hearts preserved for 24 hours.…”

Section: Discussionmentioning

confidence: 99%