Comparison of high glucose concentration blood and crystalloid cardioplegia in paediatric cardiac surgery: a randomized clinical trial

• Published in: Interactive cardiovascular and thoracic surgery 2016-05, Vol.22 (5), p.553-560
• Main Authors: Mimic, Branko, Ilic, Slobodan, Vulicevic, Irena, Milovanovic, Vladimir, Tomic, Danijela, Mimic, Ana, Stankovic, Sanja, Zecevic, Tatjana, Davies, Ben, Djordjevic, Miroslav
• Format: Article
• Language: English
• Subjects: Blood Glucose - metabolism; Cardiac Surgical Procedures - methods; Child, Preschool; Dose-Response Relationship, Drug; Female; Glucose - administration & dosage; Heart Arrest, Induced - methods; Heart Defects, Congenital - blood; Heart Defects, Congenital - surgery; Humans; Incidence; Infant; Isotonic Solutions - pharmacology; Male; Myocardial Reperfusion Injury - epidemiology; Myocardial Reperfusion Injury - prevention & control; Original; Serbia - epidemiology; Ventricular Function, Left - drug effects
• ISSN: 1569-9293; 1569-9285
• DOI: 10.1093/icvts/ivv391

OBJECTIVES This study investigates the effects of high glucose content on patients undergoing cold crystalloid versus cold blood cardioplegia in terms of early clinical results, functional myocardial recovery and ischaemia–reperfusion injury in patients undergoing repair of acyanotic cardiac lesions. METHODS Patients were randomly assigned to receive either crystalloid (n = 31) or blood cardioplegia (n = 31). Early clinical results were assessed. Changes in left ventricular fractional shortening, arterial blood lactate levels, central venous saturation, cardiac Troponin I release and blood glucose concentration were measured during the first 24 h after ischaemia. RESULTS There was no significant difference in clinical outcomes and postoperative complication rates between groups. The postoperative changes in left ventricular function, lactate levels, central venous saturation and Troponin I were not significantly different between groups. The use of crystalloid cardioplegia was associated with significant increases in serum glucose compared with blood cardioplegia. CONCLUSIONS A high glucose content blood cardioplegia does not show any advantage compared with crystalloid cardioplegia in terms of clinical outcomes, functional recovery and the degree of ischaemic injury in infants and children undergoing repair of acyanotic heart lesions. High glucose concentration of the cardioplegic solution might potentiate ischaemia–reperfusion injury and diminish the beneficial effects of blood cardioplegia.