Modified del Nido versus blood cardioplegia in congenital cardiac surgery
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Issued Date
2022-06-01
Resource Type
ISSN
02184923
eISSN
18165370
Scopus ID
2-s2.0-85115612847
Pubmed ID
34553609
Journal Title
Asian Cardiovascular and Thoracic Annals
Volume
30
Issue
5
Start Page
555
End Page
560
Rights Holder(s)
SCOPUS
Bibliographic Citation
Asian Cardiovascular and Thoracic Annals Vol.30 No.5 (2022) , 555-560
Suggested Citation
Sithiamnuai P., Tocharoenchok T. Modified del Nido versus blood cardioplegia in congenital cardiac surgery. Asian Cardiovascular and Thoracic Annals Vol.30 No.5 (2022) , 555-560. 560. doi:10.1177/02184923211048332 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85859
Title
Modified del Nido versus blood cardioplegia in congenital cardiac surgery
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: Lactated Ringer-based del Nido cardioplegia has been reported to be safe for acquired cardiac surgery. The original Plasma-Lyte-based solution has been proved for congenital cardiac surgery but its modification has not been adequately examined. We compared the clinical outcomes of congenital cardiac surgery using lactated Ringer-based del Nido cardioplegia versus cold blood cardioplegia. Methods: Between September 2018 and November 2020, 116 consecutive patients with congenital heart disease undergoing operations with cardioplegic arrest performed by a single surgeon at Faculty of Medicine Siriraj hospital; 66 with modified del Nido solution and 50 with institutional's blood cardioplegia. The patient risk profiles, operative details, mortality rates, care durations, inotrope use, blood transfusion and complications were compared. Results: Preoperative characteristics were similar between groups, including median age (2.5 vs. 3.1 years; p = 0.49), size, and gender. The Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery score of 3 to 5 was more prevalent in the del Nido group (24.2% vs. 10%; p = 0.049). There were 4 deaths in the modified del Nido group (risk category score of 4) but none in the cold blood group (p = 0.13). There was no significant difference in median intubation duration, length of intensive care unit stay, and vasoactive medications immediately and 24 h after the operation. The del Nido group required 70 to 100 ml less blood transfusion (p = 0.04). All complications were similar between the two groups. Conclusions: Clinical outcomes of lactated Ringer-based del Nido cardioplegia were comparable to those of blood cardioplegia in congenital cardiac surgery.