The myocardial protective effects of a moderate-potassium adenosine–lidocaine cardioplegia in pediatric cardiac surgery

Abstract

The MPAL cardioplegia formula was associated with better myocardial protective effects.

Hyperkalemic cardioplegia for adult and pediatric surgery: end of an era?

“…However, there was a trend toward higher number days spent in hospital and high potassium in the cardioplegia. The total post-operative hospital time for the high K + group was 12.7 ± 1.2 days, followed by high K + (AL) (11.8 ± 0.6 days) and the lowest was in the moderate 10 mM K + (AL) group (11.1 ± 1.4 days) (Jin et al, 2008). Furthermore, there were significantly higher systolic and pulse pressures following CPB in the 10 mM K + (AL) group compared with the non-AL 20 mM K + group, and again after modified ultrafiltration.…”

“…Jin and colleagues (Jin et al, 2008) conducted a prospective, single-center, randomized clinical trial involving 134 pediatric patients with low-risk congenital heart disease. On the day of surgery, surgeons and intensive care physicians were blinded to three crystalloid cardioplegic formulations; high potassium group (K + , 20 mM), high potassium AL group (20 mM K + , 0.7 mM A, 0.7 mM L) and moderate potassium AL group (10 mM K + , 0.7 mM A, 0.7 mM L).…”

The myocardial protective effects of adenosine pretreatment in children undergoing cardiac surgery: a randomized controlled clinical trial

“…Urine output was also measured. Inotropic support at each time point was quantified by calculating the inotropic score as described previously [13,14].…”

Clinically relevant animal models needed to advance state of the art fluid resuscitation*

“…Many of us still hope for a magic adenosine bullet. These present data from Granfeldt et al (3) add to other promising myocardial protective effects for adenosine-related compounds both in animal models (12) and in patients (13) and should stimulate a new generation of investigators. We can be cautiously optimistic, but it is appropriate to point out that in the past 40 yrs, there have been numerous studies showing benefit with several other adenosine regulating agents (alone or in combination with hypertonic resuscitation) in various hemorrhagic shock models, but none have translated into clinical success.…”