Evaluation of the Effect of Del Nido and Cold Blood Cardioplegia on Renal Functions in the Surgery of Congenital Heart Diseases

Abstract

Objectives:We aimed to evaluate the effect of del Nido (DN) and cold blood (CB) cardioplegia on renal functions in children undergoing cardiac surgery for congenital heart disease (CHD). Methods: This study was conducted prospectively. One hundred and nineteen pediatric patients with Risk Adjustment for Congenital Heart Surgery (RACHS) scores below 3 were randomly assigned using allocation software to two groups (CB and DN cardioplegia) according to the type of cardioplegia solution used. The change of urea, creatinine, estimated glomerular filtration rate (eGFR), and renal near-infrared spectroscopy (NIRS) values before and after cardioplegia were the primary outcome measures of this study. Results: Cardiopulmonary bypass (CPB) duration (p<0.001), ACC duration (p<0.001), and extubation time (p=0.032) were longer and the VIS-48th h (p=0.048) value was higher in the DN group. The pre-operative versus 48th h increase in urea were higher in the DN group (p=0.028). The increase in CPB duration was predictive for the increase in urea (p=0.009) and creatinine (p=0.004), and younger age was a predictor for the increase in urea (p=0.014) and decrease in eGFR (p=0.044). Conclusion:Although CPB duration, aortic cross-clamp times, and extubation times are longer in DN cardioplegia recipients, it is as safe as blood cardioplegia in terms of ICU LOS, mortality rates, VIS-initial and VIS-24th h values, and changing renal NIRS, creatinine, eGFR, and urea values during surgery. There is a need for more extensive research on the use of DN cardioplegia in CHD surgery.