Ericsson A B, Takeshima S, Vaage J
Department of Thoracic Surgery, Karolinska Hospital, Stockholm, Sweden.
Ann Thorac Surg. 1999 Aug;68(2):454-9. doi: 10.1016/s0003-4975(99)00759-6.
This study was performed to investigate the effect of temperature of blood cardioplegia on the recovery of postischemic cardiac function.
Pigs on cardiopulmonary bypass were subjected to global ischemia (30 minutes), followed by cold (n = 10) or warm (n = 11) continuous antegrade blood cardioplegia (45 minutes) delivered at 55-60 mm Hg.
Global left ventricular function, evaluated by preload recruitable stroke work, decreased with cold cardioplegia from 91 (85-103) [mean (quartile interval)], at baseline, to 73 (55-87) erg x 10(3)/mL postbypass (p = 0.03), but was unchanged after warm cardioplegia; 110 (80-132) to 109 (71-175) erg x 10(3)/mL (p > 0.5). However, the difference between treatment effects was not significant (p = 0.25). Diastolic function, evaluated by end-diastolic pressure-volume relation, deteriorated without any difference between groups. Mean cardioplegic flow was similar between groups. Coronary vascular resistance increased at constant rate during warm cardioplegic delivery, but remained unchanged with cold cardioplegia (p = 0.001 between regression coefficients).
No significant difference was found in postischemic functional recovery comparing cold and warm continuous blood cardioplegia. Cold cardioplegia is therefore preferred due to added safety of hypothermia.
本研究旨在探讨血液停搏液温度对缺血后心脏功能恢复的影响。
接受体外循环的猪经历全心缺血（30分钟），随后分别接受冷（n = 10）或温（n = 11）持续顺行血液停搏液灌注（45分钟），灌注压力为55 - 60 mmHg。
通过可招募前负荷搏功评估的全心左心室功能，冷停搏液灌注后从基线时的91（85 - 103）[均值（四分位数间距）]降至体外循环后73（55 - 87）erg x 10(3)/mL（p = 0.03），而温停搏液灌注后无变化；从110（80 - 132）降至109（71 - 175）erg x 10(3)/mL（p > 0.5）。然而，治疗效果之间的差异不显著（p = 0.25）。通过舒张末期压力 - 容积关系评估的舒张功能恶化，两组之间无差异。两组的平均停搏液流量相似。在温停搏液灌注期间冠状动脉血管阻力以恒定速率增加，而冷停搏液灌注时保持不变（回归系数之间p = 0.001）。
比较冷和温持续血液停搏液，缺血后功能恢复未发现显著差异。因此，由于低温增加了安全性，冷停搏液更受青睐。
