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Composition of cardioplegic solutions used in nine medical centers
Insights
Cardioplegic solutions used in the Coronary Artery Surgery Study (CASS) varied but shared common components like chloride and potassium. This data can guide the development of new cardioplegic solutions for cardiac surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Biochemistry
Background:
- Cardioplegic solutions are crucial for myocardial protection during cardiac surgery.
- The Coronary Artery Surgery Study (CASS) involved multiple institutions, offering a unique opportunity to assess current practices.
Purpose of the Study:
- To survey institutions participating in the CASS regarding their cardioplegic solution usage.
- To identify common components and preparation methods of cardioplegic solutions.
Main Methods:
- A short-answer questionnaire was distributed to 11 CASS institutions.
- Follow-up questionnaires were sent to non-respondents.
- Data from 9 returned questionnaires were analyzed.
Main Results:
- Four institutions used multiple cardioplegic solutions, totaling 14 evaluable solutions.
- Common components included chloride and potassium in all solutions.
- Dextrose, bicarbonate, and sodium were frequently used in chemical-based solutions.
- Chemical-based solutions had daily compounding or a one-week expiration, while blood-based solutions required daily preparation.
Conclusions:
- Despite interinstitutional variations in dosage, cardioplegic solutions in the CASS shared many similar components.
- The gathered data can serve as a guideline for developing standardized cardioplegic solutions.
Abstract:
Eleven institutions that participated in the Coronary Artery Surgery Study (CASS) were surveyed to obtain information about the types of cardioplegic solutions used at these institutions. A short-answer questionnaire designed to obtain specific information about the composition and method of preparation of cardioplegic solutions was sent to each institution. Institutions that did not reply within four weeks were sent a second questionnaire. Nine institutions returned completed questionnaires. Four institutions used several different cardioplegic solutions, resulting in a total of 14 evaluable solutions. Six hospitals used a chemical-based cardioplegic solution, one used a blood-based solution, and two used a combination of blood and chemicals as a cardioplegic-solution base. Chloride and potassium were found in all 14 solutions, although the amounts varied widely. Dextrose was included in eight of the nine chemical-based solutions, and bicarbonate and sodium were each used in seven of the nine solutions. Centers using chemical-based cardioplegic solutions compounded them daily or froze them with a one-week expiration date; blood-based solutions had to be prepared daily. Although interinstitutional differences in dosage were evident, the cardioplegic solutions used in the institutions participating in the CASS had many similar components. Data on the composition of these solutions can be used as a guideline for developing a cardioplegic solution.