Preconditioning during warm blood cardioplegia

OBJECTIVE: Preconditioning describes the cardioprotective effects ofmultiple brief episodes of warm ischemia. The purpose of the study was todetermine whether warm ischemia, during the intermittent delivery of warmblood cardioplegia, would induce preconditioning during cardioplegiaarrest. METHODS: D...

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Bibliographic Details
Published in:European journal of cardio-thoracic surgery 1997-06, Vol.11 (6), p.1113-1117
Main Authors: LANDYMORE, R, YOU, J, MURPHY, T, FRIS, J
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia depending on type of surgery
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Biological and medical sciences
Disease Models, Animal
Dogs
Evaluation Studies as Topic
Heart Arrest, Induced - methods
Hemodynamics
Ischemic Preconditioning, Myocardial
Medical sciences
Random Allocation
Temperature
Thoracic and cardiovascular surgery. Cardiopulmonary bypass
Ventricular Function, Left
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Summary:OBJECTIVE: Preconditioning describes the cardioprotective effects ofmultiple brief episodes of warm ischemia. The purpose of the study was todetermine whether warm ischemia, during the intermittent delivery of warmblood cardioplegia, would induce preconditioning during cardioplegiaarrest. METHODS: Dogs, 15, were randomized to a preconditioning protocol orto serve as controls. The control group received 60 min of continuous warmblood cardioplegia (WBC) followed by 30 min of warm arrested ischemia. Thepreconditioned group were arrested with WBC and then underwent threeconsecutive cycles consisting of 10 min of warm ischemia followed by 10 minof reperfusion. Reperfusion was provided by a continuous infusion of WBC.The preconditioning protocol was followed by 30 min of warm arrestedischemia. Myocardial functional recovery was assessed beforecardiopulmonary bypass and cardioplegia arrest and again 30, 60 and 90 minafter the arrest. Pressure-volume loops were used to measure the maximumelastance of the left ventricle (Emax), diastolic compliance, and used tocalculate preload recruitable stroke work area. RESULTS: Myocardialfunctional recovery was better preserved after 30 min of warm arrestedischemia in those animals that had been preconditioned. CONCLUSION:Preconditioning may be induced when warm blood cardioplegia is deliveredintermittently during cardioplegia arrest.
ISSN:1010-7940
1873-734X
DOI:10.1016/S1010-7940(97)01196-2