Evaluation of the cardioprotective effects of crystalloid del Nido cardioplegia solution via a rapid and accurate cardiac marker: heart-type fatty acid-binding protein

Abstract

Background/aim: Our aim in this study was to compare the efficacy and safety of crystalloid del Nido solution and cold blood cardioplegia solution on clinical and laboratory parameters. Materials and methods: Sixty patients who underwent elective coronary bypass operation between July 2019 and January 2020 were included in our study. Patients were divided into 2 groups of 30 patients using del Nido solution (DNS) and cold blood cardioplegia solution (CBCS), which were given for cardiac arrest. Demographic data, preoperative, postoperative 0th h, 6th h and 4th day creatine kinase myocardial band (CK-MB) and troponin I values were compared with a specific cardiac enzyme heart-type fatty acid-binding protein (H-FABP). Results: We found that aortic cross clamp duration and cardiopulmonary bypass (CPB) time were shorter in patients using del Nido solution than cold blood cardioplegia solution (57.30 ± 23.57 min, 76.07 ± 27.18 min, P = 0.006) (95.07 ± 23.06 min, 114.13 ± 33.93, P = 0.014). Total cardioplegia solution volume was higher in the cold blood cardioplegia solution group (1426.67 ± 416.00 vs. 1200 ± 310.73 P = 0.02). Preoperative and postoperative levels of cardiac enzymes including CK-MB, troponin I and H-FABP were comparable in del Nido solution and cold blood cardioplegia solution groups. Conclusion: According to these results, when we compare both demographic data and CK-MB, troponin I and H-FABP levels, both cardioplegia solutions were comparable regarding safety and efficacy in terms of myocardial protection.

Del Nido cardioplegia for myocardial protection in adult cardiac surgery: a systematic review and update meta-analysis

“…Forty-one studies regarding DNC versus CC for myocardial protection used in adult cardiac surgery were included in the final analysis. 7,8,20–58 On the basis of 9 retrospective observational studies we had previously included, another 32 studies published after September 2016 were included. Four of these studies were randomized controlled trials (RCTs), 24,36,39,43 one was a prospective observational study 20 while the rest were retrospective observational studies.…”

“…7,8,20–58 On the basis of 9 retrospective observational studies we had previously included, another 32 studies published after September 2016 were included. Four of these studies were randomized controlled trials (RCTs), 24,36,39,43 one was a prospective observational study 20 while the rest were retrospective observational studies. Observational studies were analyzed with the NOS, 23 of them were identified as high quality, while 14 were judged moderate quality (see Supplemental Table 1).…”

“…Thirty-eight and 39 studies respectively involving 21,391 and 21,595 patients reported CPB 7,8,20–31,33,35–42,44–58 and ACC time. 7,8,20–33,35–42,44…”

“…Twenty-four 7,8,21–24,26,28,29,33,36,38,39,41,42,44,48,50,52–55,57,58 and 13 studies 8,23,36,37,39,42–44,51–53,55,56 respectively presented the incidences of atrial fibrillation and myocardial infarction, including 5289 and 1504 patients. The use of DNC was not associated with an increased incidence of atrial fibrillation (RR: 1.02, 95% CI: 0.87 to 1.19, p = 0.83, see Supplemental Figure 3C) or myocardial infarction (RR: 1.14, 95% CI: 0.83 to 1.56, p = 0.41, see Supplemental Figure 3D).…”

“…A total of 23 studies involving 3676 patients reported the ICU stay time. 7,8,21,23–28,35,37,39,41,42,44,48,50,51,53–57 The duration of hospital stay was recorded in 22 studies involving 3918 patients, 7,8,23,24,26–28,33,35–37,39,41,42,44,48,51,53–57 whereas operative mortality was reported in 37 studies. 7,8,20–28,30–39,41…”