ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Michael Dewar
Peter E. Blundell
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dewar, M.
Right arrow Articles by Chiu, R. C.- J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dewar, M.
Right arrow Articles by Chiu, R. C.- J.

Ann Thorac Surg 1987;43:409-415
© 1987 The Society of Thoracic Surgeons

Articles

Is High Potassium Solution Necessary for Reinfusions in "Multidose" Cold Cardioplegia? A Randomized Prospective Study Using Computerized Holter System

Michael Dewar, M.D., Michael D. Rosengarten, M.D., Roger Samson, C.P., Carin Wittnich, D.V.M., Peter E. Blundell, M.D., Ray C.-J. Chiu, M.D. Ph.D.*

Divisions of Cardiovascular and Thoracic Surgery and of Cardiology, Montreal General Hospital and McGill University, Montreal, Que, Canada

Accepted for publication July 15, 1986.

* Address reprint requests to Dr. Chiu, The Montreal General Hospital, 1650 Cedar Ave, Room 947, Montreal, Que, Canada H3G 1A4

Multidose potassium cardioplegia is a common method of myocardial preservation. Although initial potassium arrest conserves high-energy phosphates, there is conflicting evidence that repeat high potassium boluses augment this protection. Fifty-six patients were prospectively randomized to receive multidose cold high potassium cardioplegia (27 mEq of KCl/L) both in the initial and subsequent infusions (Group 1) or an initial cold high potassium (27 mEq/L) cardioplegia followed by boluses of cold low potassium (7 mEq, of KCl/L) solution (Group 2).

The two groups were compared in terms of postoperative myocardial electrical stability and hemodynamic performance. Electrocardiograms were recorded by continuous Holter monitor, and the data were analyzed by computer. The duration of aortic cross-clamping and cardiopulmonary bypass did not differ between groups. Group 1, who received more total KCl than Group 2 (p < .005), experienced more high-grade ventricular ectopia during both reperfusion (p < .001) and the immediate postoperative period (p < .001), and required more lidocaine hydrochloride (p < .001) for arrhythmias. There was no significant difference in hemodynamic performance between the two groups. This study fails to show an advantage to multidose "high potassium" cardioplegia and found a significant increase in ventricular ectopia associated with its use. We advocate using low potassium solutions after initial cold high potassium arrest.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1987 by The Society of Thoracic Surgeons.