Back to Search
Start Over
Myocardial oxygen consumption during histidine-tryptophan-ketoglutarate cardioplegia in young human hearts
- Source :
- Interact Cardiovasc Thorac Surg
- Publication Year :
- 2020
-
Abstract
- OBJECTIVES Energy demand and supply need to be balanced to preserve myocardial function during paediatric cardiac surgery. After a latent aerobic period, cardiac cells try to maintain energy production by anaerobic metabolism and by extracting oxygen from the given cardioplegic solution. Myocardial oxygen consumption (MVO2) changes gradually during the administration of cardioplegia. METHODS MVO2 was measured during cardioplegic perfusion in patients younger than 6 months of age (group N: neonates; group I: infants), with a body weight less than 10 kg. Histidine-tryptophan-ketoglutarate crystalloid solution was used for myocardial protection and was administered during a 5-min interval. To measure pO2 values during cardioplegic arrest, a sample of the cardioplegic fluid was taken from the inflow line before infusion. Three fluid samples were taken from the coronary venous effluent 1, 3 and 5 min after the onset of cardioplegia administration. MVO2 was calculated using the Fick principle. RESULTS The mean age of group N was 0.2 ± 0.09 versus 4.5 ± 1.1 months in group I. The mean weight was 3.1 ± 0.2 versus 5.7 ± 1.6 kg, respectively. MVO2 decreased similarly in both groups (min 1: 0.16 ± 0.07 vs 0.36 ± 0.1 ml/min; min 3: 0.08 ± 0.04 vs 0.17 ± 0.09 ml/min; min 5: 0.05 ± 0.04 vs 0.07 ± 0.05 ml/min). CONCLUSIONS We studied MVO2 alterations after aortic cross-clamping and during delivery of cardioplegia in neonates and infants undergoing cardiac surgery. Extended cardioplegic perfusion significantly reduces energy turnover in hearts because the balance procedures are both volume- and above all time-dependent. A reduction in MVO2 indicates the necessity of a prolonged cardioplegic perfusion time to achieve optimized myocardial protection.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Immature myocardium
030204 cardiovascular system & hematology
Fick principle
Histidine-tryptophan-ketoglutarate
03 medical and health sciences
Congenital
0302 clinical medicine
Myocardial oxygen consumption
Oxygen Consumption
Medicine
Animals
Humans
In patient
Histidine
030212 general & internal medicine
Cardioplegic Solutions
Aorta
Myocardial protection
Energy demand
Crystalloid cardioplegia
business.industry
Myocardium
Infant, Newborn
Tryptophan
Heart
Crystalloid Solutions
Coronary Vessels
Cardiac surgery
Perfusion
Anesthesia
Heart Arrest, Induced
Ketoglutaric Acids
Surgery
Cardiology and Cardiovascular Medicine
business
Anaerobic exercise
Subjects
Details
- ISSN :
- 15699285
- Volume :
- 32
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Interactive cardiovascular and thoracic surgery
- Accession number :
- edsair.doi.dedup.....36a0db25e490940359268ac789c9b6fb