Department of Physiology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan.
Department of Cardiovascular Surgery, King Edward Medical University, Lahore 54000, Pakistan.
Medicina (Kaunas). 2021 Aug 31;57(9):918. doi: 10.3390/medicina57090918.
: Cardioplegia is one of the most significant components used to protect the myocardium during cardiac surgery. There is a paucity of evidence regarding the utilization of whole-blood Del Nido cardioplegia (WB-DNC) on clinical outcomes in coronary artery bypass grafting (CABG). The purpose of this retrospective cross-sectional study is to compare the effectiveness of diluted (blood to crystalloid; 1:4) Del Nido cardioplegia (DNC) with WB-DNC in patients who underwent elective CABG in a tertiary care hospital in Lahore-Pakistan. : This was a retrospective descriptive study conducted at the Department of Cardiovascular Surgery, King Edward Medical University, Lahore. The medical database of all consecutive patients admitted from January 2018 to March 2020 and who fulfilled the inclusion criteria were reviewed. : Out of 471 patients admitted during the study period, 450 underwent various elective cardiac surgeries. Out of 450, 321 patients (71.33%) were operated on for CABG. Only 234/321 (72.89%) CABG patients fulfilled our inclusion criteria; 120 (51.28%) patients received WB-DNC, while 114 (48.71%) patients were administered with DNC. The former group presented with better clinical outcomes compared with the latter in terms of lesser requirements of inotropic support, low degree of hemodilution, shorter in-hospital stay, improved renal function, and cost-effectiveness. Peak values of serum Troponin-T (Trop-T), creatine kinase-myocardial band (CK-MB) release, and activated clotting time (ACT) were also lower in the WB-DNC group compared with the DNC group. : The WB-DNC conferred better myocardial protection, improved early clinical outcomes, and also proved to be economical for patients undergoing elective CABG compared with classical crystalloid cardioplegia solution.
心脏停搏液是心脏手术中保护心肌的最重要成分之一。关于全血 Del Nido 心脏停搏液（WB-DNC）在冠状动脉旁路移植术（CABG）中的临床效果，证据有限。本回顾性横断面研究的目的是比较在巴基斯坦拉合尔一家三级护理医院接受择期 CABG 的患者中，稀释（血液与晶体液 1:4）Del Nido 心脏停搏液（DNC）与 WB-DNC 的效果。
这是在拉合尔爱德华国王医科大学心血管外科系进行的回顾性描述性研究。回顾了 2018 年 1 月至 2020 年 3 月期间所有连续入院并符合纳入标准的患者的医疗数据库。
在研究期间，有 471 名患者入院，其中 450 名接受了各种择期心脏手术。在 450 名患者中，有 321 名（71.33%）患者接受了 CABG 手术。只有 234/321（72.89%）CABG 患者符合我们的纳入标准；120 名（51.28%）患者接受了 WB-DNC，114 名（48.71%）患者接受了 DNC。与后者相比，前者在需要正性肌力支持、低程度血液稀释、住院时间更短、肾功能改善和成本效益方面具有更好的临床结果。与 DNC 组相比，WB-DNC 组的血清肌钙蛋白 T（Trop-T）、肌酸激酶同工酶-心肌带（CK-MB）释放和激活凝血时间（ACT）峰值也较低。
与传统的晶体心脏停搏液相比，WB-DNC 可提供更好的心肌保护，改善早期临床结果，并且对接受择期 CABG 的患者来说也是经济的。
