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Cardioplegic solution: a contamination crisis.

C F Hughes, A F Grant, B D Leckie

    The Journal of Thoracic and Cardiovascular Surgery
    |February 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

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    Contaminated cardioplegic solution led to severe complications, including death and mycotic aneurysms, in cardiac surgery patients. Prompt recognition of gram-negative septicemia is crucial for survival.

    Area of Science:

    • Cardiology
    • Infectious Disease
    • Surgical Complications

    Background:

    • Cardioplegic solutions are critical for cardiac surgery.
    • Contamination of medical solutions can lead to severe patient outcomes.
    • Enterobacter cloacae is a gram-negative bacterium that can cause opportunistic infections.

    Purpose of the Study:

    • To report on the adverse events in patients who received cardioplegic solution contaminated with Enterobacter cloacae.
    • To highlight the clinical features and management of gram-negative septicemia in this context.
    • To recommend preventative measures and diagnostic approaches.

    Main Methods:

    • Retrospective analysis of eleven patients who received contaminated cardioplegic solution.
    • Review of clinical data, including complications, treatments, and outcomes.

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  • Identification of clinical indicators for gram-negative septicemia.

    • Main Results:

    • Five out of eleven patients died.
    • Eight patients experienced early bleeding requiring reoperation, with significant blood and platelet transfusions.
    • Four patients developed mycotic aneurysms, with only one survivor.
    • Other complications included adult respiratory distress syndrome, renal failure, sternal infections, and organic brain syndrome.

    Conclusions:

    • Contaminated cardioplegic solutions pose a significant risk of mortality and morbidity.
    • Early recognition and treatment of gram-negative septicemia are vital, with specific clinical signs to consider.
    • Recommendations include immediate use of freshly prepared cardioplegic solutions and routine culturing of sternal blood.