Crystalloid hypothermic and blood normothermic cardioplegia

Bayandin, N. L.

doi:10.33029/2308-1198-2020-8-1-80-89

Cited by 2 publications

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“…Similar safety and tolerability were demonstrated of both solutions. 8 The mechanism of action of the N TM solution is based on the composition of electrolytes, the main of which is potassium. An influx of potassium depolarizes the myocardial membrane causing contraction and thus release and subsequent sequestration of calcium ions resulting in a diastolic arrest.…”

Section: Introductionmentioning

confidence: 99%

The retrospective observational study of clinical outcomes of single dose infusion of warm blood cardioplegia in patients undergoing cardiac surgery

Чернов

Ivashchenko

Mandel

2021

Preprint

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Objective: The aim of the study was to assess the safety and efficacy of a normothermic cardioplegia solution N trademark use and obtain additional information about dosing regimens during normothermic or mild hypothermic cardiac surgery. Methods: A retrospective observational study included 150 cardio surgery patients. The primary endpoint was the intraoperative acute heart failure development. The secondary endpoints were the postoperative Troponin T concentrations, the need for catecholamine support, and the repeated infusion of a cardioplegia solution. Results: The duration of aortic cross-clamping varied from 17 to 154 minutes, median 59 [interquartile range, 46 - 73] minutes. Spontaneous sinus rhythm recovery was observed in 136 (90.7%) patients. Intraoperative acute heart failure was observed in 1 case. The Troponin T concentrations were 0.331 plus-or-minus sign 0.143 ng/mL after surgery. Mortality was 2% (3 patients). Eight patients received an additional volume of N trademark solution to maintain asystole. Among 16 patients with a cross-clamp duration greater than 90 minutes epinephrine was used in 3 (18.8%) patients in doses of more than 0.05 mcg/kg/min. Among 134 patients cross-clamp duration less than 90 minutes the catecholamine support was used in 4 (3%) patients, p=0.027. Conclusions: A primary single-dose infusion of cardioplegia solution N trademark provides myocardial protection for 59 (interquartile range, 46-73) minutes and up to 154 minutes. The catecholamine support in the group of aortic cross-clamp duration less than 90 minutes was used lesser than in the group of aortic cross-clamp duration greater than 90 minutes (3% and 18.8%, respectively). The cardioprotection during cardiopulmonary bypass surgery especially in elderly patients with concomitant disease needs to be confirmed in future investigations.

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Section: Introductionmentioning

confidence: 99%

The retrospective observational study of clinical outcomes of single dose infusion of warm blood cardioplegia in patients undergoing cardiac surgery

Чернов

Ivashchenko

Mandel

2021

Preprint

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Pharmaceutical Market of Cardioplegic Drugs and Features of Their Application in Russia

Ovod

Новикова

2021

Mediko-farmacevtičeskij žurnal "Pulʹs"

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Relevance. Surgical treatment of cardiovascular diseases with the use of artificial blood circulation is associated with the need to protect the myocardium. Various cardioplegic solutions are widely used in cardiac surgery to stop and protect the heart. Currently, a significant number of mixtures of drug solutions are used in "open" heart surgery. However, not all of them have been officially registered as cardioplegic solutions and not all have the appropriate indications in the instructions for medical use of the drug, which jeopardizes the safety and quality of medical care for patients. Goal. To study the pharmaceutical market of registered drugs for cardioplegia and to estimate the share of heart operations with the connection of artificial circulation performed without the use of officially registraited drugs for cardioplegia. Materials and methods. The following methods were used in the work: content analysis, statistical, marketing, graphic. The main information sources were: the State Register of Medicines; statistical indicators of surgical interventions in cardiac surgery, information on public procurement of medicines, instructions for the medical use of medicines, regulatory documents. Results. This study presents the results of a marketing analysis of the pharmaceutical market of drugs officially registered for cardioplegia. Three medicines have been registraited in Russia, which, in accordance with the instructions for use, can be used during surgical interventions in the quality of cardioplegic solutions. According to the ATC classification, all of them belong to the subgroup of the fifth level B05XA16 "Cardioplegic solutions". For the period 2018-2020. the volumes of purchases of cardioplegic solutions for the needs of medical organizations have been established and the volumes of drugs for surgical intervention in cardiac surgery during operations on the "open" heart have been determined. The comparison of morbidity rates and the estimated number of surgical interventions of the cardiac surgery service based on the data of public procurement of drugs for cardioplegia, revealed a discrepancy between the volumes of purchased cardioplegic solutions and the care provided. The data analysis shows that at least 23 thousand cardiac surgeries in Russia are performed annually without the use of registraited medicines for cardioplegia. Conclusion. When performing surgical interventions on an "open" heart with the connection of artificial blood circulation, it is necessary to use cardioplegic solutions that have an official indication in the instructions for medical use, in order to ensure the safety of patients and to perform medical interventions of appropriate quality.

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Crystalloid hypothermic and blood normothermic cardioplegia

Cited by 2 publications

References 0 publications

The retrospective observational study of clinical outcomes of single dose infusion of warm blood cardioplegia in patients undergoing cardiac surgery

The retrospective observational study of clinical outcomes of single dose infusion of warm blood cardioplegia in patients undergoing cardiac surgery

Pharmaceutical Market of Cardioplegic Drugs and Features of Their Application in Russia

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