HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bical, O. M. Articles by Vanetti, A. Search for Related Content PubMed PubMed Citation Articles by Bical, O. M. Articles by Vanetti, A.

European Journal of Cardio-Thoracic Surgery, Vol 10, 417-421, Copyright © 1996 by European Association for Cardio-thoracic Surgery

ARTICLES

Effects of two different crystalloid cardioplegic solutions assessed by myocardial pH, tissue lactate content and energy metabolism

OM Bical, MF Gerhardt, D Paumier, D Gaillard, P Landais, Y Fromes, JC Foiret, F Trivin and A Vanetti
Department of Cardiac Surgery, Hospital Saint Joseph, Paris, France.

OBJECTIVE: The influence of composition of crystalloid cardioplegia is imprecise in clinical practice. Therefore, we investigated changes in intramyocardial pH, tissue lactate content and energy metabolism during cardioplegic arrest with 2 different crystalloid cardioplegic solutions. METHODS: Twenty patients were randomly allocated to 2 groups: 10 patients had crystalloid cardioplegia buffered with bicarbonate (neutral pH of 7.8 at 20 degrees) with no additives (St Thomas' II solution) and 10 patients had a non buffered crystalloid cardioplegia (mildly acidic pH of 7.4 at 20 degrees) enriched with glutamate and mannitol (Menasche's solution). Tissue lactate and energy metabolism were measured on myocardial biopsy specimens and intramyocardial pH were continuously measured during cardioplegic arrest by a miniature glass electrode. RESULTS: There were no statistical differences in hemodynamic results and in AMP, ADP, ATP, lactate values measured on biopsy specimens. The curves of intramyocardial pH were very similar in the 2 groups, the median values were 7.42 +/- 0.1 in group 1 and 7.41 +/- 0.1 in group 2 (temperature corrected values) and the areas under the curves were 260 +/- 4 and 259 +/- 4 in groups 1 and 2 respectively (P = NS). CONCLUSIONS: Glutamate provided no additive metabolic myocardial protection, bicarbonate had a weak buffering capacity in cold cardioplegic solutions and the 2 studied crystalloid solutions warranted a good myocardial protection in clinical practice.