Normokalemic adenosine-lidocaine cardioplegia: importance of maintaining a polarized myocardium for optimal arrest and reanimation

The Journal of Thoracic and Cardiovascular Surgery
Kathryn L Sloots, Geoffrey P Dobson

Abstract

Depolarizing potassium cardioplegia does not afford optimal cardioprotection in pediatric or adult patients requiring complicated operative procedures. Polarizing adenosine-lidocaine cardioplegia has been shown to be cardioprotective without hyperkalemia. Our aim was to examine the effects of changing extracellular potassium levels in adenosine-lidocaine cardioplegia on arrest and reanimation properties. Isolated-perfused rat hearts (n = 96) were arrested at 32 degrees C to 33 degrees C for 1 or 2 hours with intermittent 200 mumol/L adenosine and 500 mumol/L lidocaine in modified Krebs-Henseleit buffer with 0.1, 3.0, 5.9, 10, and 16 mmol/L potassium or with 16 or 25 mmol/L potassium in Krebs-Henseleit buffer (n = 8 for each group). Membrane potentials were estimated in the arrested ventricular myocardium (n = 42), and recovery function was measured in working mode during 60 minutes' reperfusion. Arrest was interrupted by breakout beats in the adenosine-lidocaine hypokalemic (0.1 and 3 mmol/L potassium) and non-adenosine-lidocaine hyperkalemic (16 and 25 mmol/L potassium) groups. The membrane potentials for the non-adenosine-lidocaine 16 and 25 mmol/L potassium groups were -51 and -39 mV, and those for the adenosine-lidocaine gr...Continue Reading

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Citations

Jul 24, 2013·General Thoracic and Cardiovascular Surgery·Hiroshi Yamamoto, Fumio Yamamoto
Jul 8, 2010·The Journal of Thoracic and Cardiovascular Surgery·Donna M Rudd, Geoffrey P Dobson
May 18, 2013·The Journal of Thoracic and Cardiovascular Surgery·Øyvind Jakobsen, Tor Steensrud
Jul 17, 2012·International Journal of Cardiology·Francesco OnoratiGiuseppe Faggian
Jul 12, 2011·The Journal of Thoracic and Cardiovascular Surgery·Donna M Rudd, Geoffrey P Dobson
Feb 24, 2016·Perfusion·Geoff Lockwood
Dec 20, 2015·The Journal of Trauma and Acute Care Surgery·Geoffrey Phillip Dobson, Hayley Louise Letson

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