Hisatomi K, Isomura T, Hayashida N, Sato T, Kosuga K, Aoyagi S
Second Department of Surgery, Faculty of Medicine, Kagoshima University, Japan.
Surg Today. 1996;26(6):395-9. doi: 10.1007/BF00311925.
The effect of the addition of albumin to crystalloid cardioplegic solutions was investigated in infants who underwent open heart surgery. The patients were divided into four groups according to whether or not they received a composition of crystalloid cardioplegic solutions containing albumin. Cardioplegic solution (Kurume solution) without albumin was administered to 12 patients (group 1); Kurume solution with 1% albumin to 10 patients (group 2); GIK solution without albumin to 10 patients (group 3); and GIK solution with 1% albumin to 15 patients (group 4). All patients had a ventricular septal defect and underwent closure of the defect with Dacron double velours through either the tricuspid or pulmonary valve. Our results showed that the percent oxygen extraction in group 2 was significantly greater than that in group 1, while the value in group 4 was less than that in group 3 at 5 min after reperfusion. No significant differences were seen between groups 1 and 2, or between groups 3 and 4, regarding the value for creatine kinase muscle-brain (MB) for any measurements during reperfusion. However, regarding the percent lactate and the malondialdehyde extraction values, significant differences between the groups with and without albumin were noted 5 min after reperfusion. These results did not completely support the addition of albumin to crystalloid cardioplegic solutions to help preserve myocardial aerobic metabolism in infants; however, such an addition might contribute to the preservation of myocardial lactate utilization while also helping to inhibit lipoperoxide metabolism immediately after reperfusion.
在接受心脏直视手术的婴儿中，研究了向晶体心脏停搏液中添加白蛋白的效果。根据患者是否接受含白蛋白的晶体心脏停搏液成分，将其分为四组。12例患者接受不含白蛋白的心脏停搏液（久留米溶液）（第1组）；10例患者接受含1%白蛋白的久留米溶液（第2组）；10例患者接受不含白蛋白的GIK溶液（第3组）；15例患者接受含1%白蛋白的GIK溶液（第4组）。所有患者均患有室间隔缺损，并通过三尖瓣或肺动脉瓣用涤纶双绒进行缺损修补。我们的结果显示，再灌注5分钟后，第2组的氧摄取百分比显著高于第1组，而第4组的值低于第3组。在再灌注期间的任何测量中，第1组和第2组之间，或第3组和第4组之间，肌酸激酶同工酶（MB）的值均无显著差异。然而，关于乳酸百分比和丙二醛摄取值，再灌注5分钟后，含白蛋白组和不含白蛋白组之间存在显著差异。这些结果并不完全支持在晶体心脏停搏液中添加白蛋白以帮助维持婴儿心肌有氧代谢；然而，这种添加可能有助于维持心肌乳酸利用，同时也有助于在再灌注后立即抑制脂质过氧化代谢。
