Department of Cardiothoracic and Vascular Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, India.
Perfusion. 2021 Jul;36(5):476-481. doi: 10.1177/0267659120961921. Epub 2020 Nov 17.
The role of cardioplegia cannot be underrated in cardiac surgery. St Thomas solution is the most widely used cardioplegic, but needs repeated dosing. Del Nido solution provides long duration of asystole with adequate protection; but has been used mainly in paediatric patients. This study was aimed to compare Del Nido cardioplegia with St Thomas cardioplegia in adult cardiac surgeries, requiring double valve replacement and compare the outcomes.
This retrospective, observational, descriptive study was conducted over a time period spanning from January 2016 to December 2019. A total of 209 patients were included and were separated in two groups DC group (n = 114) and BC group (n = 95) on the basis of cardioplegic solution used. Del Nido solution was administered as single dose. Parameters noted were CPB time, cross clamp time, wean off bypass time, DC shocks given, inotropic support required, ventilation duration, duration of ICU and hospital stay.
There was significantly shorter aortic cross clamp time (72.6 ± 10.2 vs. 98.2 ± 9.2), CPB time (92.1 ± 12.3 vs.129.5 ± 11) and wean off bypass time (19.4 ± 5.9 vs. 31.3 ± 7.6) and less requirement of DC shocks (21.2% vs. 65.9%) in DC group. Inotropic requirement in immediate post-operative period was significantly less in DC group both on day of surgery (5.35 ± 1.44 vs. 7.52 ± 3.8) and 24 hours later (3.4 ± 2.12 vs. 2.18 ± 0.72). There was no significant difference in duration of ventilation, ICU and hospital stay.
Del Nido can be used safely in long duration adult cardiac surgeries and in a single dose with better intra operative and immediate post-operative outcomes as compared to St Thomas solution.
心脏手术中，心脏停搏液的作用不可低估。托马斯液是最广泛使用的心脏停搏液，但需要重复给药。-del Nido 液能提供长时间的心脏停搏，并有足够的保护作用；但主要用于儿科患者。本研究旨在比较-del Nido 心脏停搏液与托马斯心脏停搏液在成人心脏手术中的作用，这些手术需要双瓣置换，并比较结果。
这是一项回顾性、观察性、描述性研究，于 2016 年 1 月至 2019 年 12 月进行。共有 209 名患者纳入研究，并根据使用的心脏停搏液分为两组：dc 组（n=114）和 bc 组（n=95）。给予-del Nido 溶液单次剂量。记录的参数包括体外循环时间、主动脉阻断时间、体外循环脱机时间、给予 dc 电击次数、需要正性肌力支持、通气时间、重症监护病房和住院时间。
dc 组的主动脉阻断时间（72.6±10.2 vs.98.2±9.2）、体外循环时间（92.1±12.3 vs.129.5±11）和体外循环脱机时间（19.4±5.9 vs.31.3±7.6）明显更短，需要 dc 电击的次数也更少（21.2% vs.65.9%）。dc 组术后即刻儿茶酚胺的需求也明显减少，手术当天（5.35±1.44 vs.7.52±3.8）和术后 24 小时（3.4±2.12 vs.2.18±0.72）。两组通气时间、重症监护病房和住院时间无显著差异。
与托马斯溶液相比，-del Nido 可安全用于成人心脏手术时间较长的患者，且单次剂量即可获得更好的术中及术后即刻效果。
