Minatoya K, Okabayashi H, Shimada I, Tanabe A, Nishina T, Nandate K, Kunihiro M
Division of Cardiovascular Surgery, Kokura Memorial Hospital, Fukuoka, Japan.
Ann Thorac Surg. 2000 Jan;69(1):74-6. doi: 10.1016/s0003-4975(99)01384-3.
Intermittent delivery of warm cardioplegia provides a bloodless surgical field, but it is clinically important to evaluate the periods of normothermic ischemia. The aims of this study are to compare intermittent antegrade warm blood cardioplegia (IAWBC) with intermittent antegrade cold blood cardioplegia (IACBC) groups in terms of myocardial protection, and also to evaluate whether the length of ischemic time in the IAWBC group has an effect on myocardial dysfunction.
This study is based on a retrospective review of patients who underwent elective coronary artery bypass surgery: 162 consecutive patients with IAWBC and 107 consecutive patients with IACBC.
The creatinine kinase peak was smaller in the IAWBC group compared with the IACBC group (p<0.0001). The cardiac index after cardiopulmonary bypass was higher in the IAWBC group (p<0.02), and the amount of inotropic support required to wean from cardiopulmonary bypass was less in the IAWBC group compared with the IACBC group (p<0.0001).
IAWBC with 30 minutes of ischemia provides to be clinically acceptable myocardial protection for coronary bypass surgery.
间歇性灌注温血心脏停搏液可提供无血手术视野，但评估常温缺血时间在临床上具有重要意义。本研究的目的是比较间歇性顺行温血心脏停搏液（IAWBC）组和间歇性顺行冷血心脏停搏液（IACBC）组在心肌保护方面的差异，并评估IAWBC组缺血时间的长短是否对心肌功能障碍有影响。
本研究基于对接受择期冠状动脉旁路移植术患者的回顾性分析：连续162例接受IAWBC的患者和连续107例接受IACBC的患者。
与IACBC组相比，IAWBC组的肌酸激酶峰值较小（p<0.0001）。体外循环后IAWBC组的心指数较高（p<0.02），与IACBC组相比，IAWBC组从体外循环撤离所需的正性肌力支持量较少（p<0.0001）。
缺血30分钟的IAWBC为冠状动脉旁路移植术提供了临床上可接受的心肌保护。
Zotero 插件