Azar I, Satyanarayana T, Turndorf H
J Thorac Cardiovasc Surg. 1981 Apr;81(4):516-8.
Potassium cardioplegia for myocardial preservation is being used extensively in heart operations. This study was designed to determine the effect of potassium cardioplegia on serum and urine potassium levels. A control group of 11 patients was compared to a study group of 24 patients. Myocardial preservation in the control group was achieved by whole body cooling to 20 degrees to 30 degrees C and in the study group, by repeated injections every 30 minutes of 500 to 700 ml of cold pump blood, containing potassium chloride 30 mEq/L, into the aortic root after aortic clamping. Total potassium dose in the study group was 46 +/- 21 mEq (mean +/- SD). Mean serum potassium level was significantly higher during and after bypass in the study group (after bypass: control 3.65 +/- 0.11 mEq/L, study 4.24 +/- 0.10 mEq/L [mean +/- SE], p less than 0.005), but was within normal limits in both groups. Urine potassium levels and excretion rates were significantly higher in the study group (potassium excretion rate after bypass: control 6.1 +/- 0.7 mEq/hr, study 11.3 +/- 0.9 mEq/hr [mean +/- SE], p less than 0.0025). We conclude that no special measures are required to facilitate potassium excretion when total potassium cardioplegia dose is not greater than 50 mEq.
钾停搏液用于心脏手术中的心肌保护已被广泛应用。本研究旨在确定钾停搏液对血清和尿钾水平的影响。将11例患者的对照组与24例患者的研究组进行比较。对照组通过将全身冷却至20℃至30℃来实现心肌保护,而研究组则在主动脉阻断后,每隔30分钟向主动脉根部重复注射500至700ml含30mEq/L氯化钾的冷泵血。研究组的总钾剂量为46±21mEq(平均值±标准差)。研究组在体外循环期间和之后的平均血清钾水平显著更高(体外循环后:对照组3.65±0.11mEq/L,研究组4.24±0.10mEq/L[平均值±标准误],p<0.005),但两组均在正常范围内。研究组的尿钾水平和排泄率显著更高(体外循环后钾排泄率:对照组6.1±0.7mEq/小时,研究组11.3±0.9mEq/小时[平均值±标准误],p<0.0025)。我们得出结论,当总钾停搏液剂量不大于50mEq时,无需采取特殊措施促进钾排泄。