Myocardial protection of warm blood cardioplegic induction during cardiopulmonary bypass

Abstract

In his prospective randomized clinical study, we evaluated the myocardial protection of warm blood cardioplegic induction and cold blood cardioplegic induction, respectively, during cardiopulmonary bypass. Twenty-eight adult patients who underwent valve replacement were randomly divided into two groups: group T (14 cases) received cold (6-8°C) blood cardioplegic induction after ECG showed straight line induced by warm (35-37°C) blood cardioplegia; whereas, group C (14 cases) received cold blood cardioplegic induction only. The effects of myocardial protection of both cardioplegic inductions were evaluated by clinical outcomes, myocardial biochemistry index (cardiac troponin T, cTnT), and myocardial automorphology. The ratio of myocardial auto resuscitation was significantly higher in group T (93%) than that in group C (50%). Only one case in group T (7%) and three cases in group C (21%) needed temporary pacemakers. No case in group T (0%) and five cases (36%) in group C received dopamine. The postoperative mechanical ventilation time and ICU stay time of group T were shorter than those of group C. Myocardial biochemistry index - plasma level of cTnT in group T was lower than that of group C immediately and 6 h after cardiopulmonary bypass. Myocardial morphology - group T had comparably better outcomes than group C. We concluded that warm blood cardioplegic induction during cardiopulmonary bypass, compared with cold blood cardioplegic induction, provides better myocardial protection.