Clinical Outcomes and Electrolyte Balance Factors in Complex Cardiac Operations in Adults; Del Nido® Versus Custodiol® Cardioplegia Solutions: A Randomized Controlled Clinical Trial
نویسندگان
1 Department of Cardiothoracic Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Cardiothoracic Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Anesthesiology and Critical Care Medicine, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
5 Iranian Scientific Society of Extracorporeal Technology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
6 Department of Basic and Clinical Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
7 Department of Anesthesiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
8 Department of Anesthesiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
9 Cardiovascular Surgery Department, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
10 Cardiovascular Surgery Department, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
11 Department of Cardiothoracic Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
doi
10.5812/ircmj.64648.چکیده
Background: Cardioplegia is used for protection of myocardium during cardiac operations. Del Nido® (DN) and Custodiol® car- dioplegia (CC) solutions are used for prolonged protection of the myocardium during cardiopulmonary bypass (CPB). Custodiol® cardioplegia solution is gaining popularity for myocardial protection during cardiopulmonary bypass. Objectives: This study aimed to compare the effects of Custodiol® with another cardioplegia solution, Del Nido®, on myocardial protection during cardiopulmonary bypass. Methods: In a randomized controlled clinical trial, forty patients were randomly allocated to Del Nido® and Custodiol® (CC) groups. Patients in both groups received a standard anesthesia protocol. For cardioplegia, in the DN group, the Del Nido® solution was administered every 90 minutes by the antegrade route. In the CC, group, the Custodiol® solution was administered in the same way at the beginning of the cardioplegia. Demographic information, blood chemistry parameters and other related perioperative andpostoperative clinical indices were recorded. Results: Frequency of female patients was 14/21 (66.66%) in the DN and 12/19 (63.15%) in the CC group (P = 0.816), age was 57.14 ± 12.48 years versus 59.47 ± 11.96 years (P = 0.551), weight was 70.95 ± 9.56 kilograms versus 69.63 ± 7.64 kilograms (P = 0.635), CPB time was 103.19 ± 23.43 minutes versus 97.36 ± 16.7 minutes (P = 0.376), and cross-clamp time was 73.76 ± 19.66 minutes versus 83.95 ± 16.14 minutes (P = 0.083). Blood chemistry and blood gas analysis revealed a similar trend between the two groups in these parameters (P> 0.05) except for higher sodium levels after cardioplegia (P = 0.016) and end of CPB (P = 0.002), potassium levels after cardioplegia (P = 0.029), and bicarbonate anions at the end of bypass (P = 0.03) in the Custodiol® group.Conclusions: In conclusion, CC and DN offer effective myocardial protection during cardiopulmonary bypass. It is recommended to restrict the use of CC in patients susceptible to electrolyte disturbances
