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Suominen PK, Keski-Nisula J, Tynkkynen P, Kantoluoto S, Olkkola KT, Mildh L. The effect of tepid amino acid-enriched induction cardioplegia on the outcome of infants undergoing cardiac surgery. Perfusion 2012; 27:338-44. [DOI: 10.1177/0267659112442237] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Despite promising experimental results, no information has been published on the clinical effects of amino acid-enriched induction cardioplegic solution on outcome in children undergoing cardiac surgery. Methods: This is a retrospective study of 185 consecutive patients younger than 12 months with one of the following defects undergoing open heart surgery: atrioventricular septal defect, transposition of the great arteries, tetralogy of Fallot or ventricular septal defect. Patients were divided into two groups according to the following myocardial protection approaches: tepid substrate-enriched induction cardioplegia followed by cold blood cardioplegia (n=113) or only cold blood induction cardioplegia (n=72). Patient allocation was determined by the anesthesiologist in charge of cardiopulmonary bypass (CPB). The primary outcome measure was postoperative myocardial injury assessed by troponin T level and inotrope score. Results: Demographic data were similar for both groups. Cardioplegic induction had no overall effect for inotrope score (16.3 ± 9.2 vs.17.9 ± 10.0, p=0.276) or lactate release (1.8 ± 1.3 vs. 1.6 ± 0.8, p=0.110) on arrival to the paediatric intensive care unit. On the first postoperative day, there were no significant differences between the cardioplegia groups for inotrope score (13.7 ± 8.7 vs.14.3 ± 9.1, p=0.657), troponin T (2.4 ± 1.6 vs. 2.8 ± 2.7 μg/L, p=0.267), lactate (1.5 ± 2.0 vs. 1.5 ± 0.8, p=0.972), or any of the other clinical outcome measures. Conclusions: Compared to cold cardioplegia alone, the administration of tepid induction cardioplegia had no effect on the clinical outcome of infants who underwent cardiac surgery.
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Affiliation(s)
- PK Suominen
- Department of Anesthesia and Intensive Care, Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - J Keski-Nisula
- Department of Anesthesia and Intensive Care, Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - P Tynkkynen
- Department of Anesthesia and Intensive Care, Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - S Kantoluoto
- Department of Anesthesia and Intensive Care, Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland
| | - KT Olkkola
- Department of Anesthesiology, Intensive Care, Emergency Care and Pain Medicine, University of Turku and Turku University Hospital, Finland
| | - L Mildh
- Department of Anesthesia and Intensive Care, Meilahti Hospital, Helsinki University Central Hospital, Finland
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