Myocardial protection with oxygenated esmolol cardioplegia during prolonged normothermic ischemia in the rat

Abstract

Oxygenation of esmolol cardioplegia (Krebs-Henseleit buffer plus 1.0 mmol/L esmolol) was essential for optimal myocardial protection. Multidose infusion of oxygenated esmolol cardioplegia provided good myocardial protection during extended periods of normothermic ischemia. Esmolol cardioplegia may provide an efficacious alternative to hyperkalemia.

Myocardial Protection in Neonates and Infants: What have we Learnt? Where do we Go?

“…A strategy of periodic replenishment of cardioplegia in such patients, though cumbersome at times,would maintain arrest, maintain uniformity of myocardial hypothermia, buffer acidosis, wash away metabolic end products, replenish high energy phosphates and restore depleted substrates. However, some studies point out that repeated multi-dose infusions with topical cooling may cause more harm than good in paediatric population, even when high energy phosphate bonds are adequately preserved [52].This might be attributed to the high content of potassium in the cardioplegia and resultant myocardial edema. Esmolol based multi dosing cardioplegia strategy has been reported as an acceptable and safe alternative to depolarizing hyperkalemic cardioplegic solutions [52].…”

“…However, some studies point out that repeated multi-dose infusions with topical cooling may cause more harm than good in paediatric population, even when high energy phosphate bonds are adequately preserved [52].This might be attributed to the high content of potassium in the cardioplegia and resultant myocardial edema. Esmolol based multi dosing cardioplegia strategy has been reported as an acceptable and safe alternative to depolarizing hyperkalemic cardioplegic solutions [52].…”

Solução cardioplégica polarizante: estado da arte

“…At high concentrations (approximately 1.0 mmol/L), it is capable of inducing cardiac arrest [48,49]. Several infusions of solutions with 1.0 mmol/L of esmolol (for 2 minutes at 15 to 45 mmHg) gave total protection to rat hearts submitted to crystalloid cardioplegia over periods of more than 90 minutes at normothermia [49,50].…”

Effect of short-acting beta blocker on the cardiac recovery after cardiopulmonary bypass

“…Also, cardioplegia contained esmolol, an ultra-short acting (9-minute half-life) cardioselective beta blocker [3], has cardioprotection in animal model and clinical patients [4-7]. However few studies have investigated beta-adrenergic antagonist on the details of the cardiac recovery and rhythm during CPB.…”