| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 2000;69:1799-1805
© 2000 The Society of Thoracic Surgeons
a Department of Thoracic and Cardiovascular Surgery, Medical School, University of Tromsø, Tromsø, Norway
b Department of Medical Physiology, Medical School, University of Tromsø, Tromsø, Norway
Address reprint requests to Dr Elvenes, Department of Thoracic and Cardiovascular Surgery, Institute of Clinical Medicine, University of Tromsø, N-9038 Tromsø, Norway
e-mail: oddpe{at}fagmed.uit.no
Background. Warm continuous blood cardioplegia (WCBCP) has been recommended during prolonged cardiac arrest to minimize functional deterioration. Myocardial metabolism and efficiency after this cardioplegic modality are not well described.
Methods. Substrate oxidation, blood flow, and myocardial function were measured before, during, and after 3 hours of WCBCP in 7 pigs.
Results. Free fatty acid and glucose oxidation decreased by 60% ± 3.8% and 94% ± 1.2%, respectively, during cardioplegia (both p < 0.05) and increased to 62% ± 28% and 122% ± 62% of baseline during the early recovery phase (p < 0.05 for glucose). One hour after WCBCP oxidation rates were similar to baseline. The transient postcardioplegic increase in substrate oxidation was associated with a 43% ± 23% elevation of oxygen consumption (MVO2) compared with baseline and a 62% ± 18% increase in myocardial blood flow. Cardiac output and mean arterial pressure did not change significantly after WCBCP, although myocardial function (stroke work, left ventricular end-systolic pressure, end-diastolic pressure, contractility, and efficiency) was depressed (p < 0.05). End-diastolic pressure and contractility improved from early to late phase of recovery, whereas the other indicators of ventricular function remained depressed.
Conclusions. Myocardial substrate oxidation was preserved after 3 hours of WCBCP, although ventricular function was moderately impaired. Thus, WCBCP with a seemingly normal substrate and oxygen supply was associated with a reduced cardiac efficiency.
This article has been cited by other articles:
|
|
 |
|
  S. Mierdl, D. Meininger, S. Dogan, G. Wimmer-Greinecker, K. Westphal, D. H. Bremerich, and C. Byhahn Does poor oxygenation during one-lung ventilation impair aerobic myocardial metabolism in patients with symptomatic coronary artery disease? Interactive CardioVascular and Thoracic Surgery, April 1, 2007; 6(2): 209 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. A. G. Louagie, J. Jamart, M. Gonzalez, E. Collard, S. Broka, L. Galanti, and A. Gruslin Continuous cold blood cardioplegia improves myocardial protection: a prospective randomized study Ann. Thorac. Surg., February 1, 2004; 77(2): 664 - 671. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Steensrud, D. Nordhaug, O.P. Elvenes, C. Korvald, and D.G. Sorlie Superior myocardial protection with nicorandil cardioplegia Eur. J. Cardiothorac. Surg., May 1, 2003; 23(5): 670 - 677. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. P. Elvenes, C. Korvald, R. Myklebust, and D. Sorlie Warm retrograde blood cardioplegia saves more ischemic myocardium but may cause a functional impairment compared to cold crystalloid Eur. J. Cardiothorac. Surg., September 1, 2002; 22(3): 402 - 409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Korvald, O. P. Elvenes, T. Myrmel, and D. G. Sorlie Cardiac dysfunction and inefficiency after substrate-enriched warm blood cardioplegia Eur. J. Cardiothorac. Surg., September 1, 2001; 20(3): 555 - 564. [Abstract] [Full Text] [PDF]
|
|
| 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 |
