Comparison of Warm Blood Cardioplegia Delivery With or Without the Use of a Roller Pump.

Journal: The journal of extra-corporeal technology
Published Date:

Abstract

Various techniques for administration of blood cardioplegia are used worldwide. In this study, the effect of warm blood cardioplegia administration with or without the use of a roller pump on perioperative myocardial injury was studied in patients undergoing coronary artery bypass grafting using minimal extra-corporeal circuits (MECCs). Sixty-eight patients undergoing elective coronary bypass surgery with an MECC system were consecutively enrolled and randomized into a pumpless group (PL group: blood cardioplegia administration without roller pump) or roller pump group (RP group: blood cardioplegia administration with roller pump). No statistically significant differences were found between the PL group and RP group regarding release of cardiac biomarkers. Maximum postoperative biomarker values reached at T1 (after arrival intensive care unit) for heart-type fatty acid binding protein (2.7 [1.5; 6.0] ng/mL PL group vs. 3.2 [1.6; 6.3] ng/mL RP group, p = .63) and at T3 (first postoperative day) for troponin T high-sensitive (22.0 [14.5; 29.3] ng/L PL group vs. 21.1 [15.3; 31.6] ng/L RP group, p = .91), N-terminal pro-brain natriuretic peptide (2.1 [1.7; 2.9] ng/mL PL group vs. 2.6 [1.6; 3.6] ng/mL RP group, p = .48), and C-reactive protein (138 [106; 175] μg/mL PL group vs. 129 [105; 161] μg/mL RP group, p = .65). Besides this, blood cardioplegia flow, blood cardioplegia line pressure, and aortic root pressure during blood cardioplegia administration were similar between the two groups. Administration of warm blood cardioplegia with or without the use of a roller pump results in similar clinically acceptable myocardial protection.

Authors

  • Mizja M Faber
    Department of Extracorporeal Circulation, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Peter G Noordzij
    Department of Anaesthesiology, Intensive Care and Pain Management, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Simon Hennink
    Department of Anaesthesiology, Intensive Care and Pain Management, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Hans Kelder
    Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Roel de Vroege
    Department of Extracorporeal Circulation, Haga Hospital, The Hague, The Netherlands.
  • Frans G Waanders
    Department of Extracorporeal Circulation, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Edgar Daeter
    Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Marco C Stehouwer
    Department of Extracorporeal Circulation, St. Antonius Hospital, Nieuwegein, The Netherlands.