Effect of the addition of albumin to crystalloid cardioplegic solutions on myocardial metabolism in infants undergoing open heart surgery.

The effect of the addition of albumin to crystalloid cardioplegic solutions was investigated in infants who underwent open heart surgery. The patients were divided into four groups according to whether or not they received a composition of crystalloid cardioplegic solutions containing albumin. Cardioplegic solution (Kurume solution) without albumin was administered to 12 patients (group 1); Kurume solution with 1% albumin to 10 patients (group 2); GIK solution without albumin to 10 patients (group 3); and GIK solution with 1% albumin to 15 patients (group 4). All patients had a ventricular septal defect and underwent closure of the defect with Dacron double velours through either the tricuspid or pulmonary valve. Our results showed that the percent oxygen extraction in group 2 was significantly greater than that in group 1, while the value in group 4 was less than that in group 3 at 5 min after reperfusion. No significant differences were seen between groups 1 and 2, or between groups 3 and 4, regarding the value for creatine kinase muscle-brain (MB) for any measurements during reperfusion. However, regarding the percent lactate and the malondialdehyde extraction values, significant differences between the groups with and without albumin were noted 5 min after reperfusion. These results did not completely support the addition of albumin to crystalloid cardioplegic solutions to help preserve myocardial aerobic metabolism in infants; however, such an addition might contribute to the preservation of myocardial lactate utilization while also helping to inhibit lipoperoxide metabolism immediately after reperfusion.