Clinical outcomes and electrolyte balance factors in complex cardiac operations in adults ; del nido ® versus custodiol ® cardioplegia solutions : a randomized controlled clinical trial

الملخص EN

Background: Cardioplegia is used for protection of myocardium during cardiac operations.

Del Nido® (DN) and Custodiol® cardioplegia (CC) solutions are used for prolonged protection of the myocardium during cardiopulmonary bypass (CPB).

Custodiol® cardioplegia solution is gaining popularity for myocardial protection during cardiopulmonary bypass.

Objectives: This study aimed to compare the effects of Custodiol® with another cardioplegia solution, Del Nido®, on myocardial protection during cardiopulmonary bypass.

Methods: In a randomized controlled clinical trial, forty patients were randomly allocated to DelNido® and Custodiol® (CC) groups.

Patients in both groups received a standard anesthesia protocol.

For cardioplegia, in the DN group, the Del Nido® solution was administered every 90 minutes by the antegrade route.

In the CC, group, the Custodiol® solution was administered in the same way at the beginning of the cardioplegia.

Demographic information, blood chemistry parameters and other related perioperative and postoperative clinical indices were recorded.

Results: Frequency of female patients was 14/21 (66.66 %) in the DN and 12/19 (63.15 %) in the CC group (P = 0.816), age was 57.1412.48 years versus 59.4711.96 years (P = 0.551), weight was 70.959.56 kilograms versus 69.637.64 kilograms (P = 0.635), CPB time was 103.1923.43 minutes versus 97.3616.7 minutes (P = 0.376), and cross-clamp time was 73.7619.66 minutes versus 83.9516.14 minutes (P = 0.083).

Blood chemistry and blood gas analysis revealed a similar trend between the two groups in these parameters (P > 0.05) except for higher sodium levels after cardioplegia (P = 0.016) and end of CPB (P = 0.002), potassium levels after cardioplegia (P = 0.029), and bicarbonate anions at the end of bypass (P = 0.03) in the Custodiol® group.

Conclusions: In conclusion, CC and DN offer effective myocardial protection during cardiopulmonary bypass.

It is recommended to restrict the use of CC in patients susceptible to electrolyte disturbances.