Topical cardiac hypothermia for myocardial preservation

Barner, Hendrick B.; Standeven, John; Jellinek, Max; Menz, Leo J.; Hahn, John W.

doi:10.1016/s0022-5223(19)41443-8

Cited by 35 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have documented the superiority of cardioplegia over general hypothermia and topical cooling alone (2 ,4,5,8,9,10,II,14,IS,19).…”

Section: Discussionmentioning

confidence: 99%

“…Different kinds of myocardial protection are used during cardiopulmonary bypass (2,9,10). Hyp othermia lowers myoca rdial metabolic activities and protects the myocardium during ischemia (9).…”

Section: Introductionmentioning

confidence: 99%

“…Cardioplegia tends to conserve high energy phosphate compounds and diminishes oxygen co nsumption during ischemic arrest (4,5,8,19). However, hypothermia alone is not able to prevent ultrastructu ral damage in the myocardium completely (2,10). Cardioplegia also cannot prevent myocardial damage in some circumstances (8,II ,12,19).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Correlation between Enzyme Release and Myocardial Ultrastructure in Two Different Types of Myocardial Protection during Cardiopulmonary Bypass

Ngalikpima¹,

Flameng²,

Stalpaert³

1982

Thorac cardiovasc Surg

View full text Add to dashboard Cite

Thi s study invest igates th e effects of ischem ic arrest on enzymat ic release (CPK, CPK•MB, LDH and SGOn in t he thea ter and dur ing th e postoper at ive hour s, and c or relat es these with ultrast rucw ral find ings. Th irty-five pat ie nts undergoing ro utine valve repl aceme nt surgery were d ivided int o 2 groups (G I, G il l and treated wit h 2 diffe re nt ty pe s of my oca rd ial prot ec tio n IMP) me thods : dee p hyp ot he rmia 25 :!: 3°C w ith topical cool ing, and deep hypo therm ia 24 t 1°c with cardioplegia (St. Thoma s'). The samples were tak en before, duri ng and after CPB and then every 2 hours fo r a furt her 4 6 hour s. Two myocardial biopsi es were take n before aort ic cross-clamping and 10 minut es afte r ao rtic cross-clamp release. Our resu lts show t hat not all th e serum enzymes are ca pab le of reflect ing the d iffere nces expec ted. Total CPK, LOH and SGOT for example , are very insensitive, while CPK-MB is more spec ific. However, co mparing the 2 groups, global significant diff erences could be o btai ned, p = 0 .05 for CPK and p < 0 .00 1 for CPK-MB. The enzymatic activity increased unt il the seco nd hou r postoper at ively in bo th groups and then a decli ne occurred. But , in Gil a seco nd phase of enzyme re lease I appeared at the 28t h hou r postoperatively. T his phenomenon can probably be related to card ioplegia. In co mparing the groups, the statistical analysis with St ude nt's T-test showed many significan tly diff erent levels from th e 32 00 un t il t he 46 th postoperat ive hou r. These levels of significa nce tended to increase wit h ti me (p = 0.025 to p < 0 .0011. On the other hand, the ultrastru ctura l investigations showe d good MP du ring ischemic arrest in all groups with o nly slight signs of ischemic injuries. The enzymat ic act ivity tended to increase and to maintain a high level in Gil wh ile it norm alized in GI. In concl usion, the enzy mat ic acti vity can be very closely related to the kinds of MP methods. The slight myocardial injuries observed in Gil can become irreversible, ex plaining t he prolonged and delayed en zyme release. However , t he possibility of late to xic effects of cardio plegia were not studied. In th is study, CPK-MB appea rs to be a bett er para meter fo r different iat ing th e groups tha n CPK, LOH and SGOT. KeyWord s: Cardio pulmona ry by pass-Myocard ial protection-Crea tine phosp hokinase-Lact ic dehyd rogenase-Serum glutamic oxalo-ecenc tra nsam inase

show abstract

“…Many studies have documented the superiority of cardioplegia over general hypothermia and topical cooling alone (2 ,4,5,8,9,10,II,14,IS,19).…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Correlation between Enzyme Release and Myocardial Ultrastructure in Two Different Types of Myocardial Protection during Cardiopulmonary Bypass

Ngalikpima¹,

Flameng²,

Stalpaert³

1982

Thorac cardiovasc Surg

View full text Add to dashboard Cite

show abstract

`Lactate Washout' Following Circulatory Arrest

Leavy

Weil²,

Rackow³

1988

JAMA

View full text Add to dashboard Cite

The measurement of arterial blood lactate concentration for the purpose of estimating the severity and prognosis of acute perfusion failure is suspect because of theoretical errors due to systemic "lactate washout" immediately following restoration of perfusion. If arterial lactate concentrations continue to increase following resuscitation, the assumption that increasing lactate concentrations indicate progression of anaerobiosis due to perfusion failure would be invalidated. Lactate washout was therefore investigated in a porcine model of cardiac arrest due to electromechanical dissociation. Cardiopulmonary resuscitation was initiated and maintained for intervals of 30 minutes or until spontaneous circulation was restored. In 25 trials on 14 successfully resuscitated animals, the arterial blood lactate concentration decreased within four minutes after resuscitation from cardiac arrest. In 24 animals in whom resuscitation efforts failed, arterial lactate concentrations increased throughout the observation period. Lactate washout occurred during an interval of only 2.6 +/- 0.3 minutes (mean +/- SEM). These results indicate that lactate measurements are not invalidated because of a washout phenomenon under the extreme conditions of cardiac arrest.

show abstract