Wilson G J, Axford-Gatley R A, Bush B G, Romaschin A D, Mickle D A
Department of Cardiovascular Surgery, Toronto General Hospital, Ontario, Canada.
Thorac Cardiovasc Surg. 1990 Feb;38(1):10-4. doi: 10.1055/s-2007-1013983.
Roe's and Bretschneider's crystalloid cardioplegic solutions were compared in a canine model of total cardiopulmonary bypass with 4.5 hours of hypothermic (27 degrees C) ischemic arrest and 60 minutes of reperfusion. Bretschneider's solution (Group I, six dogs) preserved tissue adenosine triphosphate (ATP) near control levels and maintained coronary effluent pH near 7.0 throughout the ischemic interval, while Roe's solution (Group II, six dogs) allowed progressive acidosis and depletion of ATP (P less than 0.005 versus control). Group I had supranormal left ventricular function during reperfusion (greater than 100% of pre-arrest function) but Group II regained only 40-75% of pre-arrest function. Group I had 2.82% +/- 3.61% necrosis of heart mass and Group II 9.33% +/- 8.26 (P less than 0.10). We conclude that Bretschneider's solution provided better myocardial protection than Roe's solution. The development of acidosis in the Roe group suggests that the more effective buffering of Bretschneider's solution with histidine is the probable basis for its superiority.
在一个犬类体外循环模型中，对罗伊氏和布雷施奈德氏晶体心脏停搏液进行了比较，该模型包括4.5小时的低温（27摄氏度）缺血性停搏和60分钟的再灌注。布雷施奈德氏溶液（第一组，6只狗）在整个缺血期间将组织三磷酸腺苷（ATP）维持在接近对照水平，并使冠状动脉流出液pH值维持在7.0左右，而罗伊氏溶液（第二组，6只狗）则导致渐进性酸中毒和ATP耗竭（与对照相比，P<0.005）。第一组在再灌注期间左心室功能超常（大于停搏前功能的100%），但第二组仅恢复到停搏前功能的40-75%。第一组心脏质量坏死率为2.82%±3.61%，第二组为9.33%±8.26（P<0.10）。我们得出结论，布雷施奈德氏溶液比罗伊氏溶液提供了更好的心肌保护。罗伊组酸中毒的发生表明，布雷施奈德氏溶液中组氨酸更有效的缓冲作用可能是其优越性的基础。
