PMID: 8452442Mar 1, 1993Paper

Age and protection of the ischemic myocardium: is alkaline cardioplegia appropriate?

The Annals of Thoracic Surgery
J E BakerG N Olinger

Abstract

Hypothermic alkaline pharmacologic cardioplegia used in pediatric cardiac surgery may be less than satisfactory despite its benefits in adults. We determined whether the pH (7.8) of standard St. Thomas' II cardioplegic solution contributes to inadequate protection of the ischemic immature heart and whether the effect is age-related. Modified hypothermic St. Thomas' II solution (pH range, 4.8 to 8.8) was compared with hypothermic bicarbonate buffer alone (pH 7.25) in protecting the ischemic immature (7 to 10 days old) and mature (12 months old) rabbit heart. Isolated hearts (n = 6 per group) were perfused with bicarbonate buffer, and aortic flow was measured before hypothermic (14 degrees C) ischemia (immature hearts: 4 hours; mature hearts: 3 hours). Hearts were reperfused, and enzyme leakage and recovery of function were measured. In the immature heart, a bell-shaped dose-response profile was observed for pH and recovery of aortic flow but not for postischemic creatine kinase leakage. Optimal recovery of aortic flow (98% +/- 3%) occurred at pH 6.8, which was greater than protection with hypothermia alone (82% +/- 4%; p < 0.05) and standard St. Thomas' II solution (72% +/- 2%; p < 0.05). In the mature heart, a bell-shaped dose-...Continue Reading

References

Oct 11, 1991·The Annals of Thoracic Surgery·E J BakerJ E Baker
Dec 1, 1990·The Annals of Thoracic Surgery·J E BakerG N Olinger
Sep 7, 1989·Molecular and Cellular Biochemistry·P A Poole-Wilson
Feb 1, 1970·The American Journal of Physiology·B J HowellH Rahn
Apr 1, 1967·The American Journal of Physiology·J R NeelyH E Morgan
Feb 1, 1982·Circulation Research·K D PhilipsonA Y Nishimoto
Aug 1, 1980·Journal of Molecular and Cellular Cardiology·S M Cobbe, P A Poole-Wilson

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Citations

May 9, 2003·The Annals of Thoracic Surgery·Torsten DoenstFriedhelm Beyersdorf
Jan 1, 1997·Free Radical Biology & Medicine·J E BakerB Kalyanaraman
Jun 30, 2004·The Journal of Thoracic and Cardiovascular Surgery·P ModiM Caputo
Apr 28, 2017·Expert Review of Hematology·Pedro CabralesBryan Oronsky
Jun 14, 2002·American Journal of Physiology. Heart and Circulatory Physiology·Marija Tonkovic-CapinJohn E Baker

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