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Single-Dose del Nido Cardioplegia Compared With Standard Cardioplegia During Coronary Artery Bypass Grafting at a Veterans Affairs Hospital
Texas Heart Institute Journal ( IF 0.8 ) Pub Date : 2021-05-04 , DOI: 10.14503/thij-19-6981
Michael R Reidy 1, 2 , Ernesto Jimenez 1, 2 , Shuab Omer 1, 2 , Lorraine D Cornwell 1, 2 , Sabrina X Runbeck 2 , Ourania Preventza 1, 3 , Gabriel Loor 1, 3 , Todd K Rosengart 1, 3 , Joseph S Coselli 1, 3
Affiliation  

Del Nido cardioplegic solution (DNC), used chiefly in pediatric patients, rapidly induces prolonged cardiac arrest during cardiac surgery. To determine whether surgical outcomes after coronary artery bypass grafting in a United States military veteran population differed when DNC was used instead of our standard Plegisol cardioplegia, we retrospectively reviewed 155 consecutive operations performed from July 2016 through June 2017. Del Nido cardioplegia was used to induce cardiac arrest in 70 patients, and Plegisol in 85.

Compared with the Plegisol group, the DNC group had a shorter mean cardiopulmonary bypass time (96.8 vs 117 min; P <0.01) and aortic cross-clamp time (63.9 vs 71.7 min; P=0.02). On multiple linear regression, DNC use and number of bypasses performed were predictors of cardiopulmonary bypass time. The groups were similar in median number of bypasses performed, median time to extubation, intensive care unit stay, and total postoperative stay; however, the DNC group had a shorter mean operating room time (285.8 vs 364.5 min; P <0.01). Del Nido cardioplegia, number of bypasses, cardiopulmonary bypass time, and red blood cell transfusion were predictors of operating room time. Outcomes in the groups were similar for 30- and 180-day death, stroke, renal failure, ventilation time >48 hours, atrial fibrillation, tracheostomy, reintubation, and mechanical circulatory support. We conclude that single-dose DNC is safe, effective, and cost-effective for achieving cardiac arrest in U.S. veteran populations.



中文翻译:

在退伍军人事务医院冠状动脉搭桥术中单剂量 del Nido 心麻痹与标准心麻痹的比较

Del Nido 心脏停搏液 (DNC),主要用于儿科患者,在心脏手术过程中会迅速引起长时间的心脏骤停。为了确定当使用 DNC 代替我们的标准 Plegisol 心脏停搏液时,美国退伍军人人群冠状动脉旁路移植术后的手术结果是否不同,我们回顾性审查了 2016 年 7 月至 2017 年 6 月进行的 155 次连续手术。 Del Nido 心脏停搏液用于诱导70 名患者心脏骤停,85 名 Plegisol 患者。

与 Plegisol 组相比,DNC 组的平均体外循环时间(96.8 对 117 分钟;P <0.01)和主动脉交叉钳夹时间(63.9 对 71.7 分钟;P = 0.02)更短。在多元线性回归中,DNC 的使用和执行的旁路次数是体外循环时间的预测因素。各组在执行的搭桥次数中位数、拔管时间中位数、重症监护病房住院时间和术后总住院时间方面相似;然而,DNC 组的平均手术时间较短(285.8 分钟 vs 364.5 分钟;P <0.01)。Del Nido 心脏停搏液、旁路次数、体外循环时间和红细胞输注是手术室时间的预测因素。30 天和 180 天死亡、卒中、肾功能衰竭、通气时间 >48 小时、心房颤动、气管切开术、再插管和机械循环支持的结果相似。我们得出的结论是,单剂量 DNC 是安全、有效且具有成本效益的,可在美国退伍军人人群中实现心脏骤停。

更新日期:2021-05-05
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