Biagioli B, Giomarelli P, Gnudi G, Artioli E, Simeone F, Paolini G, Marchetti L, Grossi A
Istituto di Chirurgia Toracica e Cardiovascolare, University of Siena, Italy.
Ann Thorac Surg. 1993 Dec;56(6):1315-23. doi: 10.1016/0003-4975(93)90672-5.
The theoretical advantages of retrograde blood cardioplegia combined with anterograde blood cardioplegia and warm reperfusion before aortic unclamping during coronary surgery were evaluated in 41 patients (group 2). The early postoperative myocardial function of this group was compared with that of 55 patients (group 1) in whom cold crystalloid cardioplegia was administered. The following variables were measured and analyzed by multivariate statistical analysis: heart rate, left atrial pressure, systemic arterial pressure, cardiac index, left ventricular stroke work index, ventricular function, oxygen delivery, hemoglobin, partial oxygen pressure in mixed venous blood, arteriovenous oxygen difference, carbon dioxide production per square meter, and cardiac isoenzyme of creatine-kinase. The myocardial function improved progressively and cardiac enzymatic release was low for both groups 9 hours after admission to the intensive care unit. However, group 2 had significantly higher oxygen delivery, carbon dioxide production per square meter, cardiac index, left ventricular stroke work index, and ventricular function and significantly lower left atrial pressure and mean systemic arterial pressure than that of group 1. The best separation of group 2 from group 1 occurred at the ninth hour, with a probability of correct recognition of 92.1%.
在41例患者（第2组）中评估了冠状动脉手术期间在主动脉阻断前逆行血液停搏联合顺行血液停搏及温血再灌注的理论优势。将该组患者术后早期心肌功能与55例接受冷晶体停搏液灌注的患者（第1组）进行比较。通过多变量统计分析测量和分析以下变量：心率、左心房压力、体动脉压、心脏指数、左心室每搏功指数、心室功能、氧输送、血红蛋白、混合静脉血氧分压、动静脉氧差、每平方米二氧化碳产量以及肌酸激酶心脏同工酶。在重症监护病房入院9小时后，两组的心肌功能均逐渐改善且心肌酶释放量较低。然而，第2组的氧输送、每平方米二氧化碳产量、心脏指数、左心室每搏功指数和心室功能明显高于第1组，而左心房压力和平均体动脉压明显低于第1组。第2组与第1组的最佳区分出现在第9小时，正确识别概率为92.1%。
