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KMID : 0364019940270060427
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Korean Journal of Thoracic and Cardiovascular Surgery
1994 Volume.27 No. 6 p.427 ~ p.434
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A Clinical Study on Myocardial Metabolism in Warm Versus Cold Continuous Blood Cardioplegia
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백완기
김혁/이원용/유재현/유환국/나찬영/정윤섭/김응수/한재진
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Abstract
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A clinical study was designed to evaluate myocardial metabolism during continuous cold blood cardioplegia(Group A, n=10) in comparison with continuous warm blood cardioplegia(Group B, n=10), in a prospective randomized manner.
Myocardial metabolism was assessed in two ways: either by collecting blood from coronary sinus before and after cardiopulmonary bypass or by collecting blood from cardioplegic affluent and effluent simultaneously at the beginning and at the end
of
cardioplegia. The former samples were assayed for gas analysis, lactic acid and cardiac enzyme(CK, LDH, SGOT) and the latter for gas analysis and lactic acid as a maker of anaerobic metabolism.
@ES The results were as follows.
@EN 1) Myocardial metabolism was shown to be continued in the state of cardioplegia at lower temperature as evidenced by high oxygen extraction of cardioplegic solution in Group A.
2) Anaerobic metabolism occuring at lower temperature in spite of continuous cold blood cardioplegia can be significantly reduced by continuous perfusion of normothermic blood cardioplegics as evidenced by significant reduction of lactate
production in
Group B(p<0.05).
3) Better myocardial protection can be achieved by employing continuous warm blood cardioplegia as evidenced by less cardiac enzyme release in Group B after cardiopulmonary bypass. (Korean J Thoracic Cardiovas Surg 1994; 27:427-34)
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KEYWORD
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