Intermediate lukewarm (20°c) antegrade intermittent blood cardioplegia compared with cold and warm blood cardioplegia

Chocron, Sidney; Kaili, Djamel; Yan, Yusheng; Toubin, Gérard; Latini, L.; François, Clément; Viel, Jean-François; Etievent, Joseph-Philippe

doi:10.1016/s0022-5223(00)70144-9

Cited by 21 publications

(7 citation statements)

References 20 publications

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“…Several randomized trials have evaluated tepid blood cardioplegia in elective myocardial revascularization. 8 –12 Although the clinical endpoints of operative complications and mortality were not significantly improved in these studies, echocardiographic and biochemical tests for the efficacy of myocardial protection tended to indicate that tepid blood cardioplegia was better than cold or warm blood cardioplegia.…”

Section: Discussionmentioning

confidence: 91%

Intermittent Tepid Blood Cardioplegia Improves Clinical Outcome

Tan

Ahmed

Paterson

2003

Asian Cardiovasc Thorac Ann

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Intermittent antegrade cold blood cardioplegia is the predominant method of myocardial protection, but recent studies suggest that warm or tepid blood cardioplegia may improve the return of myocardial metabolic and contractile function. Data were collected prospectively on 1,533 patients undergoing cardiopulmonary bypass in a single surgeon's practice. The use of intermittent antegrade cold (4 degrees C) blood cardioplegia in 951 consecutive patients from September 1994 to November 1997 was compared with intermittent antegrade tepid (28 degrees C) blood cardioplegia in 582 consecutive patients from July 1998 to July 2000. The two groups were similar, but the symptom class was more severe and there were more redo and combined procedures and more operations within 7 days of myocardial infarction in the tepid group. Significant clinical benefits identified in the tepid group included reduced usage of intraaortic balloon pumping postoperatively (4.4% versus 2.2%) and reduced incidence of postoperative atrial fibrillation (25.7% versus 20.6%). There was no significant difference in mortality, perioperative myocardial infarction, cerebrovascular events, or use of inotropics between the groups. Intermittent tepid blood cardioplegia is clinically appropriate and safe to use in patients undergoing cardiac surgery.

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Section: Discussionmentioning

confidence: 91%

Intermittent Tepid Blood Cardioplegia Improves Clinical Outcome

Tan

Ahmed

Paterson

2003

Asian Cardiovasc Thorac Ann

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“… 2/8 Chello et al E6 2003 CABG 20 CB: 20 37 5 Intermittent warm cardioplegia was associated with better myocardial protection, and increased HSP72 expression. 4/8 Chocron et al E7 2000 CABG 45 CB: 45 37 8 Intermittent warm blood cardioplegia was associated with comparable postoperative complications and fewer myocardial injuries in low-risk patients. 6/8 Curtis et al E8 1996 CABG 40 CB: 38 NR 4 Warm cardioplegia was associated with comparable morbidity and mortality compared with cold cardioplegia.…”

Section: Resultsmentioning

confidence: 99%

Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysis

et al. 2021

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Objective: This meta-analysis aimed to compare clinical outcomes of warm and cold cardioplegia in cardiac surgeries in adult patients, with trial sequential analysis (TSA) used to determine the conclusiveness of the results.Methods: Electronic searches were performed on PubMed, Medline, Scopus, EM-BASE, and Cochrane library to identify all studies that compared warm and cold cardioplegia in cardiac surgeries. Primary end points were in-hospital or 30-day mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, and new atrial fibrillation. Secondary end points were acute kidney injury, hospital length of stay, and intensive care unit length of stay. Prespecified subgroup analyses were performed for (1) studies published since publication of Fan and colleagues in 2010, (2) randomized controlled studies, (3) studies with low risk of bias, (4) coronary artery bypass graft surgeries, and (5) studies with cold blood versus those with cold crystalloid cardioplegia. TSA was performed to determine conclusiveness of the results, using on all outcomes without significant heterogeneity from studies of low risk of bias.Results: No significant differences were found between post-operative rates of mortality, myocardial infarction, low cardiac output syndrome, intra-aortic balloon pump use, stroke, new atrial fibrillation, and acute kidney injury between warm and cold cardioplegia. TSA concluded that current evidence was sufficient to rule out a 20% relative risk reduction in these outcomes.Conclusions: Concerning safety outcomes, current evidence suggests that the choice between warm and cold cardioplegia remains in the surgeon's preference.

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“…In a study where cardioplegic temperature was altered but cardiopulmo nary bypass was performed at normothermia, there was no difference in stroke rates between cold, tepid, or warm cardioplegia groups. 54 Similarly, in studies where both warm and cold cardioplegia were performed with systemic hypothermia, stroke rates were low and did not differ significantly. 55 Thus, we recommend that, with warm cardioplegia, systemic perfusion be maintained at 32 to 33 °C to protect the brain.…”

Section: Neurologic Complicationsmentioning

confidence: 95%

Warm Blood Cardioplegia for Myocardial Protection: Concepts and Controversies

James

Nores

Rousou

et al. 2020

Texas Heart Institute Journal

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Warm blood cardioplegia has been an established cardioplegic method since the 1990s, yet it remains controversial in regard to myocardial protection. This review will describe the physiologic and technical concepts behind warm blood cardioplegia, as well as outline the current basic and clinical research that evaluates its usefulness. Controversies regarding this technique will also be reviewed. A long history of experimental data indicates that warm blood cardioplegia is safe and effective and thus suitable myocardial protection during cardiopulmonary bypass surgeries.

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Intermediate lukewarm (20°c) antegrade intermittent blood cardioplegia compared with cold and warm blood cardioplegia

Cited by 21 publications

References 20 publications

Intermittent Tepid Blood Cardioplegia Improves Clinical Outcome

Intermittent Tepid Blood Cardioplegia Improves Clinical Outcome

Warm versus cold cardioplegia in cardiac surgery: A meta-analysis with trial sequential analysis

Warm Blood Cardioplegia for Myocardial Protection: Concepts and Controversies

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