The use of Normacor and Custodiol in protecting the heart in patients with acute coronary syndrome and coronary heart disease
Purpose of the study
Comparison of normothermic blood cardioplegia and cold cardioplegia for myocardial protection in high-risk patients.
Spontaneous restoration of heart rhythm was observed more often in patients in the Normacor group
Spontaneous restoration of heart rhythm in the Normacor® group occurred in 95.50% of cases versus 17.80% of cases in the Custodiol group.
The need for cardiotonic support was significantly lower when using Normacor
The need for cardiotonic support was significantly higher among patients in the Custodiol group, requiring it in 100.00% of cases. In the Normacor® group, cardiotonic support was required in 172 patients (15.00% of cases).
The need for increased doses of Dopamine was less frequent in the Normacor group
After cardioplegia, Normacor required dopamine significantly less (p<0.01). Dopamine dose after CPB: Normacor - 4.94±2.78 mcg/kg/h, Custodiol - 6.89±1.83 mcg/kg/h.
The volume of postoperative exudate during normothermia (Normacor) was less than during hypothermia (Custodiol)
The volume of exudate discharged through the drains was greater in the Custodiol group—678.13±10.27 ml, versus 563.93±9.48 ml in the Normacor group (p<0.001). This was due to hemodilution and the negative impact of cold on the blood coagulation properties.
Cognitive impairment test
In the Normacor group, 78% of patients scored at least 28 on the clock drawing test and MMSE after 24 hours, and 95% returned to their preoperative status. In the Custodiol group, only 44% scored 28 on the clock drawing test after 24 hours, compared to 81% by 48 hours. Cognitive recovery after 24 hours was 4.66 times higher in the Normacor group than in the Custodiol group (p=0.0000044).
Normacor · ≥28 points after 24 h
Normacor · returned to status
Custodiol · ≥28 points after 24 h
Custodiol · returned to status (48 h)
Conclusion
The use of Normacor solution for blood cardioplegia during CABG surgery promotes spontaneous restoration of cardiac contractile function and provides reliable myocardial protection with a low need for cardiotonic support.
