A retrospective observational study of clinical outcomes of single-dose warm blood cardioplegia in cardiac surgery patients
Purpose of the study
To evaluate the safety and efficacy of the normothermic cardioplegic solution Normacor® and obtain additional information on dosing regimens during normothermic or moderately hypothermic cardiac surgery.
The results of the study showed
A single Normacor® cardioplegia perfusion provides myocardial protection for an average of 59 minutes
The maximum aortic clamping time per dose was 154 minutes.
When using Normacor®, the heart effectively stopped and restored rhythm on its own
After removal of the aortic clamp, spontaneous rhythm restoration was recorded in 136 patients (90.07%). Cardiac arrest in the form of asystole was recorded in 150 patients (100%).
Spontaneous restoration of rhythm
Cardiac arrest in the form of asystole
Blood composition changed during and after the operation without significant shifts
Blood pH levels of patients. Each point represents one patient; the solid line is the median; the band is the normal range.
Potassium ion concentrations in arterial and venous blood of the patients. Solid lines represent median values; the band represents the normal range of the parameter.
When the duration of aortic cross-clamping was up to 90 minutes, catecholamine support was rarely used
Of the 16 cases with aortic clamping duration greater than 90 minutes, adrenaline was used in 3 (18.8%) patients at a dose greater than 0.05 mcg/kg/min. Of the 134 cases of aortic clamping duration less than 90 minutes, catecholamine support was used in 4 (3%) patients, p=0.027.
Aortic clamp > 90 min · adrenaline was used
Aortic clamp < 90 min · catecholamine support
One administration of Normacor® was sufficient in most cases
Repeated administration of the solution was required only in isolated cases.
- 142One dose - 142 patients
- 8Repeated dose - 8 cases
Conclusion
Normothermic solution Normacor® for blood cardioplegia can be used both for standard cardiac surgical interventions and for patients with a high risk of intraoperative complications associated with severe cardiovascular insufficiency or severe concomitant diseases.
The first dose of the solution provides myocardial protection for an average of 59 minutes. The longest surgery performed using one dose of Normacor® lasted 154 minutes.
Catecholamine support was rarely used for aortic cross-clamping durations of less than 90 minutes. Normacor® cardioplegic solution provides support for physiological myocardial metabolism and adequate myocardial protection during the intraoperative period.
