Branko Mimic1, Slobodan Ilic2, Irena Vulicevic3, Vladimir Milovanovic3, Danijela Tomic3, Ana Mimic4, Sanja Stankovic5, Tatjana Zecevic3, Ben Davies6, Miroslav Djordjevic7. 1. Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK brankomimic@gmail.com. 2. Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia School of Medicine, University of Belgrade, Belgrade, Serbia. 3. Department of Cardiac Surgery, University Children's Hospital, Belgrade, Serbia. 4. Department of Anaesthesiology, Clinical Centre of Serbia, Belgrade, Serbia. 5. Centre for Medical Biochemistry, Clinical Centre of Serbia, Belgrade, Serbia. 6. Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK. 7. School of Medicine, University of Belgrade, Belgrade, Serbia Department of Urology, University Children's Hospital, Belgrade, Serbia.
Abstract
OBJECTIVES: This study investigates the effects of high glucose content on patients undergoingcold crystalloid versus cold blood cardioplegia in terms of early clinical results, functional myocardial recovery and ischaemia-reperfusion injury in patients undergoing repair of acyanotic cardiac lesions. METHODS: Patients were randomly assigned to receive either crystalloid (n = 31) or blood cardioplegia (n = 31). Early clinical results were assessed. Changes in left ventricular fractional shortening, arterial blood lactate levels, central venous saturation, cardiac Troponin I release and blood glucose concentration were measured during the first 24 h after ischaemia. RESULTS: There was no significant difference in clinical outcomes and postoperative complication rates between groups. The postoperative changes in left ventricular function, lactate levels, central venous saturation and Troponin I were not significantly different between groups. The use of crystalloid cardioplegia was associated with significant increases in serum glucose compared with blood cardioplegia. CONCLUSIONS: A high glucose content blood cardioplegia does not show any advantage compared with crystalloid cardioplegia in terms of clinical outcomes, functional recovery and the degree of ischaemic injury in infants and children undergoing repair of acyanotic heart lesions. High glucose concentration of the cardioplegic solution might potentiate ischaemia-reperfusion injury and diminish the beneficial effects of blood cardioplegia.
RCT Entities:
OBJECTIVES: This study investigates the effects of high glucose content on patients undergoing cold crystalloid versus cold blood cardioplegia in terms of early clinical results, functional myocardial recovery and ischaemia-reperfusion injury in patients undergoing repair of acyanotic cardiac lesions. METHODS:Patients were randomly assigned to receive either crystalloid (n = 31) or blood cardioplegia (n = 31). Early clinical results were assessed. Changes in left ventricular fractional shortening, arterial blood lactate levels, central venous saturation, cardiac Troponin I release and blood glucose concentration were measured during the first 24 h after ischaemia. RESULTS: There was no significant difference in clinical outcomes and postoperative complication rates between groups. The postoperative changes in left ventricular function, lactate levels, central venous saturation and Troponin I were not significantly different between groups. The use of crystalloid cardioplegia was associated with significant increases in serum glucose compared with blood cardioplegia. CONCLUSIONS: A high glucose content blood cardioplegia does not show any advantage compared with crystalloid cardioplegia in terms of clinical outcomes, functional recovery and the degree of ischaemic injury in infants and children undergoing repair of acyanotic heart lesions. High glucose concentration of the cardioplegic solution might potentiate ischaemia-reperfusion injury and diminish the beneficial effects of blood cardioplegia.
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