St. Thomas' Hospital cardioplegia: enhanced protection with exogenous creatine phosphate
Chambers DJ, Haire K, Morley N, Fairbanks L, Strumia E, Young CP, Venn GE
The Annals of thoracic surgery · 20 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 1996-01-01 · Ann Thorac Surg · vol. 61 · número 1 · págs. 67–75
- Editorial
- Elsevier BV
- Citado
- 25 citas · más que el 64% de estudios similares · 0.4× el promedio de su campo
- Referencias
- 34 trabajos
- Acceso
- De pago
- Áreas de investigación
- Cardiac and Coronary Surgery Techniques · Cardiac Ischemia and Reperfusion · Blood transfusion and management
- Palabras clave
- cardioplegia, phosphocreatine, cardioprotection, heart valve replacement, postoperative arrhythmia, inotropic support, myocardial high-energy phosphates, myocardial ultrastructure, cardiac function recovery
- MeSH
- myocardium, heart, heart valves, humans, postoperative complications, calcium chloride, bicarbonates, potassium chloride, sodium chloride, magnesium, phosphocreatine, cardioplegic solutions, cardiotonic agents, electrocardiography, biopsy, needle, postoperative care, coronary artery bypass, heart valve prosthesis, energy metabolism, adult, aged, middle aged, female, male, arrhythmias, cardiac, hemodynamics
7 autores
- David J. Chambers🇬🇧St Thomas' Hospital
- Kevin Haire🇬🇧Guy's Hospital; St Thomas' Hospital
- Nicola Morley🇬🇧Guy's Hospital; St Thomas' Hospital
- Lynne Fairbanks🇬🇧Guy's Hospital; St Thomas' Hospital
- Ettore Strumia🇬🇧Guy's Hospital; St Thomas' Hospital
- Christopher P. Young🇬🇧Guy's Hospital; St Thomas' Hospital
- Graham E. Venn🇬🇧Guy's Hospital; St Thomas' Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Experimentally, creatine phosphate (CP) improves postischemic recovery of function and reduces postischemic arrhythmias.
Methods
We studied 50 patients undergoing valve replacement. They were randomized into either a control group, who received St. Thomas' Hospital cardioplegic solution No. 1, or a CP-treated group, receiving the same cardioplegic solution plus CP (10 mmol/L). There were no preoperative clinical differences between groups. Assessment was by electrocardiographic analysis, inotropic drug requirement, quantitative birefringence, myocardial high-energy phosphate content, function, and semiquantitative ultrastructural assessment.
Results
Direct-current shocks were reduced in the CP-treated group (0.88 +/- 0.15) compared with the control group (1.40 +/- 0.14; p < 0.02), as was the total number of joules (22.0 +/- 3.5 versus 34.4 +/- 3.7, respectively; p <0.02). The incidence of spontaneous sinus rhythm was higher in the CP-treated group (40% versus 8%; p < 0.05) and the incidence of postoperative arrhythmias, lower (8% versus 32%; p < 0.05). Prolonged inotropic administration (12 hours or longer) occurred in fewer patients in the CP-treated group (4% versus 28%; p < 0.05). Response to inotropic support (in the subset of patients requiring this treatment) was significantly greater in the CP-treated group than in the control group. There were no differences in recovery of function, birefringence changes, myocardial high-energy phosphate content, or ultrastructure between groups.
Conclusions
St. Thomas' Hospital cardioplegic solution No. 1 plus CP enhanced myocardial protection and conferred a direct benefit to the patient by reducing postoperative arrhythmias and need of prolonged inotropic support.
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