Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes
Identifieur interne : 000A15 ( Istex/Corpus ); précédent : 000A14; suivant : 000A16Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes
Auteurs : Lucia Torracca ; Evasio Pasini ; Salvatore Curello ; Claudio Ceconi ; Giuseppe Coletti ; Ottavio Alfieri ; Roberto Solfrini ; Roberto FerrariSource :
- The Annals of Thoracic Surgery [ 0003-4975 ] ; 1996.
Abstract
Background.The aim of this study was to compare the protective effects of continuous warm blood cardioplegia (CWBC) and intermittent warm blood cardioplegia (IWBC) in an experimental model of blood-perfused, isolated rabbit heart.Methods.In the CWBC group, cardiac arrest was induced by continuous infusion of blood cardioplegia (10 mEq/L KCI) followed by 30 minutes of reperfusion with blood. In the IWBC group, after 5 minutes of perfusion with blood cardioplegia (10 mEq/L KCl), coronary flow was abolished for 10 minutes, followed by reperfusion with blood cardioplegia for 5 minutes. This sequence was repeated three times for a total period of 45 minutes. Finally the hearts were reperfused for 30 minutes with blood.Results.Infusion of potassium induced a marked increase in coronary perfusion pressure (from 50 ± 3 to 98 ± 1 mm Hg; p < 0.01), which remained elevated throughout in the CWBC group, whereas in the IWBC group, it dropped to 0 during each no-flow period. In both groups, cardioplegia resulted in a significant reduction in oxygen consumption (from 5.5 ± 0.2 to 0.6 ± 0.03 mL O2 · min−1 · 100 g−1 wet wt; p < 0.01). During CWBC, glucose extraction was significantly reduced (from 152 ± 10 to 64 ± 18 μg · min−1 · g−1 wet wt; p < 0.01). Free fatty acid uptake and creatine kinase and lactate release were not affected. During IWBC, in contrast, a transient but significant release of creatine kinase (from 643 ± 254 to 2,234 ± 296 mU · min−1 · g−1 wet wt; p < 0.01) and lactate (from 63 ± 22 to 374 ± 32 μg · min−1 wet wt; p < 0.01) occurred after each period of ischemia. Despite these metabolic differences, both cardioplegic procedures allowed a prompt and complete recovery of mechanical function and tissue content of high-energy phosphates.Conclusions.Both CWBC and IWBC exert optimal protection in the isolated blood perfused rabbit heart. Thus, IWBC can be safely used to improve visualization of the surgical field.
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DOI: 10.1016/0003-4975(96)00598-X
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Italy</mods:affiliation></affiliation></author><author><name sortKey="Coletti, Giuseppe" sort="Coletti, Giuseppe" uniqKey="Coletti G" first="Giuseppe" last="Coletti">Giuseppe Coletti</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Alfieri, Ottavio" sort="Alfieri, Ottavio" uniqKey="Alfieri O" first="Ottavio" last="Alfieri">Ottavio Alfieri</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Solfrini, Roberto" sort="Solfrini, Roberto" uniqKey="Solfrini R" first="Roberto" last="Solfrini">Roberto Solfrini</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Address reprint requests to Dr Ferrari, Cattedra di Cardiologia, Università degli Studi di Brescia, c/o Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: ferrari@master.cci.unibs.it</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:8C01E83916A3B4556425FCC51D981C54CB81E6D0</idno><date when="1996" year="1996">1996</date><idno type="doi">10.1016/0003-4975(96)00598-X</idno><idno type="url">https://api.istex.fr/document/8C01E83916A3B4556425FCC51D981C54CB81E6D0/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000A15</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</title><author><name sortKey="Torracca, Lucia" sort="Torracca, Lucia" uniqKey="Torracca L" first="Lucia" last="Torracca">Lucia Torracca</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Pasini, Evasio" sort="Pasini, Evasio" uniqKey="Pasini E" first="Evasio" last="Pasini">Evasio Pasini</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Curello, Salvatore" sort="Curello, Salvatore" uniqKey="Curello S" first="Salvatore" last="Curello">Salvatore Curello</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ceconi, Claudio" sort="Ceconi, Claudio" uniqKey="Ceconi C" first="Claudio" last="Ceconi">Claudio Ceconi</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Coletti, Giuseppe" sort="Coletti, Giuseppe" uniqKey="Coletti G" first="Giuseppe" last="Coletti">Giuseppe Coletti</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Alfieri, Ottavio" sort="Alfieri, Ottavio" uniqKey="Alfieri O" first="Ottavio" last="Alfieri">Ottavio Alfieri</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Solfrini, Roberto" sort="Solfrini, Roberto" uniqKey="Solfrini R" first="Roberto" last="Solfrini">Roberto Solfrini</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name><affiliation><mods:affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>Address reprint requests to Dr Ferrari, Cattedra di Cardiologia, Università degli Studi di Brescia, c/o Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: ferrari@master.cci.unibs.it</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The Annals of Thoracic Surgery</title><title level="j" type="abbrev">ATS</title><idno type="ISSN">0003-4975</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1996">1996</date><biblScope unit="volume">62</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="1172">1172</biblScope><biblScope unit="page" to="1179">1179</biblScope></imprint><idno type="ISSN">0003-4975</idno></series><idno type="istex">8C01E83916A3B4556425FCC51D981C54CB81E6D0</idno><idno type="DOI">10.1016/0003-4975(96)00598-X</idno><idno type="PII">0003-4975(96)00598-X</idno><idno type="ArticleID">9600598X</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0003-4975</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background.The aim of this study was to compare the protective effects of continuous warm blood cardioplegia (CWBC) and intermittent warm blood cardioplegia (IWBC) in an experimental model of blood-perfused, isolated rabbit heart.Methods.In the CWBC group, cardiac arrest was induced by continuous infusion of blood cardioplegia (10 mEq/L KCI) followed by 30 minutes of reperfusion with blood. In the IWBC group, after 5 minutes of perfusion with blood cardioplegia (10 mEq/L KCl), coronary flow was abolished for 10 minutes, followed by reperfusion with blood cardioplegia for 5 minutes. This sequence was repeated three times for a total period of 45 minutes. Finally the hearts were reperfused for 30 minutes with blood.Results.Infusion of potassium induced a marked increase in coronary perfusion pressure (from 50 ± 3 to 98 ± 1 mm Hg; p < 0.01), which remained elevated throughout in the CWBC group, whereas in the IWBC group, it dropped to 0 during each no-flow period. In both groups, cardioplegia resulted in a significant reduction in oxygen consumption (from 5.5 ± 0.2 to 0.6 ± 0.03 mL O2 · min−1 · 100 g−1 wet wt; p < 0.01). During CWBC, glucose extraction was significantly reduced (from 152 ± 10 to 64 ± 18 μg · min−1 · g−1 wet wt; p < 0.01). Free fatty acid uptake and creatine kinase and lactate release were not affected. During IWBC, in contrast, a transient but significant release of creatine kinase (from 643 ± 254 to 2,234 ± 296 mU · min−1 · g−1 wet wt; p < 0.01) and lactate (from 63 ± 22 to 374 ± 32 μg · min−1 wet wt; p < 0.01) occurred after each period of ischemia. Despite these metabolic differences, both cardioplegic procedures allowed a prompt and complete recovery of mechanical function and tissue content of high-energy phosphates.Conclusions.Both CWBC and IWBC exert optimal protection in the isolated blood perfused rabbit heart. Thus, IWBC can be safely used to improve visualization of the surgical field.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Lucia Torracca MD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Evasio Pasini MD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Salvatore Curello MD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Claudio Ceconi</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Giuseppe Coletti MD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Ottavio Alfieri MD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Roberto Solfrini MD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string></affiliations></json:item><json:item><name>Roberto Ferrari MD, PhD</name><affiliations><json:string>Divisione di Cardiochirurgia, Spedali Civili, Italy</json:string><json:string>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</json:string><json:string>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</json:string><json:string>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</json:string><json:string>Address reprint requests to Dr Ferrari, Cattedra di Cardiologia, Università degli Studi di Brescia, c/o Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy</json:string><json:string>E-mail: ferrari@master.cci.unibs.it</json:string></affiliations></json:item></author><articleId><json:string>9600598X</json:string></articleId><language><json:string>eng</json:string></language><abstract>Background.The aim of this study was to compare the protective effects of continuous warm blood cardioplegia (CWBC) and intermittent warm blood cardioplegia (IWBC) in an experimental model of blood-perfused, isolated rabbit heart.Methods.In the CWBC group, cardiac arrest was induced by continuous infusion of blood cardioplegia (10 mEq/L KCI) followed by 30 minutes of reperfusion with blood. In the IWBC group, after 5 minutes of perfusion with blood cardioplegia (10 mEq/L KCl), coronary flow was abolished for 10 minutes, followed by reperfusion with blood cardioplegia for 5 minutes. This sequence was repeated three times for a total period of 45 minutes. Finally the hearts were reperfused for 30 minutes with blood.Results.Infusion of potassium induced a marked increase in coronary perfusion pressure (from 50 ± 3 to 98 ± 1 mm Hg; p > 0.01), which remained elevated throughout in the CWBC group, whereas in the IWBC group, it dropped to 0 during each no-flow period. In both groups, cardioplegia resulted in a significant reduction in oxygen consumption (from 5.5 ± 0.2 to 0.6 ± 0.03 mL O2 · min−1 · 100 g−1 wet wt; p > 0.01). During CWBC, glucose extraction was significantly reduced (from 152 ± 10 to 64 ± 18 μg · min−1 · g−1 wet wt; p > 0.01). Free fatty acid uptake and creatine kinase and lactate release were not affected. During IWBC, in contrast, a transient but significant release of creatine kinase (from 643 ± 254 to 2,234 ± 296 mU · min−1 · g−1 wet wt; p > 0.01) and lactate (from 63 ± 22 to 374 ± 32 μg · min−1 wet wt; p > 0.01) occurred after each period of ischemia. Despite these metabolic differences, both cardioplegic procedures allowed a prompt and complete recovery of mechanical function and tissue content of high-energy phosphates.Conclusions.Both CWBC and IWBC exert optimal protection in the isolated blood perfused rabbit heart. Thus, IWBC can be safely used to improve visualization of the surgical field.</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>576 x 828 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1943</abstractCharCount><pdfWordCount>7632</pdfWordCount><pdfCharCount>27356</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>326</abstractWordCount></qualityIndicators><title>Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</title><pii><json:string>0003-4975(96)00598-X</json:string></pii><genre><json:string>research-article</json:string></genre><serie><volume>3</volume><editor><json:item><name>HU Bergmeyer</name></json:item></editor><pages><last>1491</last><first>1483</first></pages><genre></genre><language><json:string>unknown</json:string></language><title>Methods of enzymatic analysis</title></serie><host><volume>62</volume><pii><json:string>S0003-4975(00)X0224-X</json:string></pii><pages><last>1179</last><first>1172</first></pages><issn><json:string>0003-4975</json:string></issn><issue>4</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>The Annals of Thoracic Surgery</title><publicationDate>1996</publicationDate></host><categories><wos><json:string>CARDIAC & CARDIOVASCULAR SYSTEMS</json:string><json:string>RESPIRATORY SYSTEM</json:string><json:string>SURGERY</json:string></wos></categories><publicationDate>1996</publicationDate><copyrightDate>1996</copyrightDate><doi><json:string>10.1016/0003-4975(96)00598-X</json:string></doi><id>8C01E83916A3B4556425FCC51D981C54CB81E6D0</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/8C01E83916A3B4556425FCC51D981C54CB81E6D0/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/8C01E83916A3B4556425FCC51D981C54CB81E6D0/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/8C01E83916A3B4556425FCC51D981C54CB81E6D0/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8C01E83916A3B4556425FCC51D981C54CB81E6D0/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1996</date></publicationStmt><notesStmt><note>This study was supported by the target project G179038C FATMA of the National Council of Research (CNR), Rome, Italy.</note><note type="content">Section title: Original article: Cardiovascular</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</title><author><persName><forename type="first">Lucia</forename><surname>Torracca</surname></persName><roleName type="degree">MD</roleName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Evasio</forename><surname>Pasini</surname></persName><roleName type="degree">MD</roleName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Salvatore</forename><surname>Curello</surname></persName><roleName type="degree">MD</roleName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Claudio</forename><surname>Ceconi</surname></persName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Giuseppe</forename><surname>Coletti</surname></persName><roleName type="degree">MD</roleName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Ottavio</forename><surname>Alfieri</surname></persName><roleName type="degree">MD</roleName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Roberto</forename><surname>Solfrini</surname></persName><roleName type="degree">MD</roleName><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation></author><author><persName><forename type="first">Roberto</forename><surname>Ferrari</surname></persName><roleName type="degree">MD, PhD</roleName><email>ferrari@master.cci.unibs.it</email><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><affiliation>Address reprint requests to Dr Ferrari, Cattedra di Cardiologia, Università degli Studi di Brescia, c/o Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy</affiliation></author></analytic><monogr><title level="j">The Annals of Thoracic Surgery</title><title level="j" type="abbrev">ATS</title><idno type="pISSN">0003-4975</idno><idno type="PII">S0003-4975(00)X0224-X</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1996"></date><biblScope unit="volume">62</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="1172">1172</biblScope><biblScope unit="page" to="1179">1179</biblScope></imprint></monogr><idno type="istex">8C01E83916A3B4556425FCC51D981C54CB81E6D0</idno><idno type="DOI">10.1016/0003-4975(96)00598-X</idno><idno type="PII">0003-4975(96)00598-X</idno><idno type="ArticleID">9600598X</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1996</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background.The aim of this study was to compare the protective effects of continuous warm blood cardioplegia (CWBC) and intermittent warm blood cardioplegia (IWBC) in an experimental model of blood-perfused, isolated rabbit heart.Methods.In the CWBC group, cardiac arrest was induced by continuous infusion of blood cardioplegia (10 mEq/L KCI) followed by 30 minutes of reperfusion with blood. In the IWBC group, after 5 minutes of perfusion with blood cardioplegia (10 mEq/L KCl), coronary flow was abolished for 10 minutes, followed by reperfusion with blood cardioplegia for 5 minutes. This sequence was repeated three times for a total period of 45 minutes. Finally the hearts were reperfused for 30 minutes with blood.Results.Infusion of potassium induced a marked increase in coronary perfusion pressure (from 50 ± 3 to 98 ± 1 mm Hg; p < 0.01), which remained elevated throughout in the CWBC group, whereas in the IWBC group, it dropped to 0 during each no-flow period. In both groups, cardioplegia resulted in a significant reduction in oxygen consumption (from 5.5 ± 0.2 to 0.6 ± 0.03 mL O2 · min−1 · 100 g−1 wet wt; p < 0.01). During CWBC, glucose extraction was significantly reduced (from 152 ± 10 to 64 ± 18 μg · min−1 · g−1 wet wt; p < 0.01). Free fatty acid uptake and creatine kinase and lactate release were not affected. During IWBC, in contrast, a transient but significant release of creatine kinase (from 643 ± 254 to 2,234 ± 296 mU · min−1 · g−1 wet wt; p < 0.01) and lactate (from 63 ± 22 to 374 ± 32 μg · min−1 wet wt; p < 0.01) occurred after each period of ischemia. Despite these metabolic differences, both cardioplegic procedures allowed a prompt and complete recovery of mechanical function and tissue content of high-energy phosphates.Conclusions.Both CWBC and IWBC exert optimal protection in the isolated blood perfused rabbit heart. Thus, IWBC can be safely used to improve visualization of the surgical field.</p></abstract></profileDesc><revisionDesc><change when="1996-05-30">Registration</change><change when="1996">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"></istex:docType><istex:document><article version="5.0" xml:lang="en" docsubtype="fla"><item-info><jid>ATS</jid><aid>9600598X</aid><ce:pii>0003-4975(96)00598-X</ce:pii><ce:doi>10.1016/0003-4975(96)00598-X</ce:doi><ce:copyright type="unknown" year="1996">The Society of Thoracic Surgeons</ce:copyright></item-info><head><ce:article-footnote><ce:note-para>This study was supported by the target project G179038C FATMA of the National Council of Research (CNR), Rome, Italy.</ce:note-para></ce:article-footnote><ce:dochead><ce:textfn>Original article: Cardiovascular</ce:textfn></ce:dochead><ce:title>Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</ce:title><ce:author-group><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Lucia</ce:given-name><ce:surname>Torracca</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Evasio</ce:given-name><ce:surname>Pasini</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Salvatore</ce:given-name><ce:surname>Curello</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Claudio</ce:given-name><ce:surname>Ceconi</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Giuseppe</ce:given-name><ce:surname>Coletti</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Ottavio</ce:given-name><ce:surname>Alfieri</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD</ce:degrees><ce:given-name>Roberto</ce:given-name><ce:surname>Solfrini</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref></ce:author><ce:author><ce:degrees>MD, PhD</ce:degrees><ce:given-name>Roberto</ce:given-name><ce:surname>Ferrari</ce:surname><ce:cross-ref refid="aff1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="aff2"><ce:sup loc="post">b</ce:sup></ce:cross-ref><ce:cross-ref refid="aff3"><ce:sup loc="post">c</ce:sup></ce:cross-ref><ce:cross-ref refid="aff4"><ce:sup loc="post">d</ce:sup></ce:cross-ref><ce:cross-ref refid="cor1"><ce:sup loc="post">*</ce:sup></ce:cross-ref><ce:e-address type="email">ferrari@master.cci.unibs.it</ce:e-address></ce:author><ce:affiliation id="aff1"><ce:label>a</ce:label><ce:textfn>Divisione di Cardiochirurgia, Spedali Civili, Italy</ce:textfn></ce:affiliation><ce:affiliation id="aff2"><ce:label>b</ce:label><ce:textfn>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</ce:textfn></ce:affiliation><ce:affiliation id="aff3"><ce:label>c</ce:label><ce:textfn>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</ce:textfn></ce:affiliation><ce:affiliation id="aff4"><ce:label>d</ce:label><ce:textfn>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</ce:textfn></ce:affiliation><ce:correspondence id="cor1"><ce:label>*</ce:label><ce:text>Address reprint requests to Dr Ferrari, Cattedra di Cardiologia, Università degli Studi di Brescia, c/o Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy</ce:text></ce:correspondence></ce:author-group><ce:date-accepted day="30" month="5" year="1996"></ce:date-accepted><ce:abstract id="ab1" class="author" xml:lang="en"><ce:abstract-sec><ce:section-title>Background.</ce:section-title><ce:simple-para view="all" id="simple-para.0010">The aim of this study was to compare the protective effects of continuous warm blood cardioplegia (CWBC) and intermittent warm blood cardioplegia (IWBC) in an experimental model of blood-perfused, isolated rabbit heart.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Methods.</ce:section-title><ce:simple-para view="all" id="simple-para.0015">In the CWBC group, cardiac arrest was induced by continuous infusion of blood cardioplegia (10 mEq/L KCI) followed by 30 minutes of reperfusion with blood. In the IWBC group, after 5 minutes of perfusion with blood cardioplegia (10 mEq/L KCl), coronary flow was abolished for 10 minutes, followed by reperfusion with blood cardioplegia for 5 minutes. This sequence was repeated three times for a total period of 45 minutes. Finally the hearts were reperfused for 30 minutes with blood.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Results.</ce:section-title><ce:simple-para view="all" id="simple-para.0020">Infusion of potassium induced a marked increase in coronary perfusion pressure (from 50 ± 3 to 98 ± 1 mm Hg; <ce:italic>p</ce:italic> < 0.01), which remained elevated throughout in the CWBC group, whereas in the IWBC group, it dropped to 0 during each no-flow period. In both groups, cardioplegia resulted in a significant reduction in oxygen consumption (from 5.5 ± 0.2 to 0.6 ± 0.03 mL O<ce:inf loc="post">2</ce:inf> · min<ce:sup loc="post">−1</ce:sup> · 100 g<ce:sup loc="post">−1</ce:sup> wet wt; <ce:italic>p</ce:italic> < 0.01). During CWBC, glucose extraction was significantly reduced (from 152 ± 10 to 64 ± 18 <ce:italic>μ</ce:italic>g · min<ce:sup loc="post">−1</ce:sup> · g<ce:sup loc="post">−1</ce:sup> wet wt; <ce:italic>p</ce:italic> < 0.01). Free fatty acid uptake and creatine kinase and lactate release were not affected. During IWBC, in contrast, a transient but significant release of creatine kinase (from 643 ± 254 to 2,234 ± 296 mU · min<ce:sup loc="post">−1</ce:sup> · g<ce:sup loc="post">−1</ce:sup> wet wt; <ce:italic>p</ce:italic> < 0.01) and lactate (from 63 ± 22 to 374 ± 32 <ce:italic>μ</ce:italic>g · min<ce:sup loc="post">−1</ce:sup> wet wt; <ce:italic>p</ce:italic> < 0.01) occurred after each period of ischemia. Despite these metabolic differences, both cardioplegic procedures allowed a prompt and complete recovery of mechanical function and tissue content of high-energy phosphates.</ce:simple-para></ce:abstract-sec><ce:abstract-sec><ce:section-title>Conclusions.</ce:section-title><ce:simple-para view="all" id="simple-para.0025">Both CWBC and IWBC exert optimal protection in the isolated blood perfused rabbit heart. 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type="alternative" lang="en" contentType="CDATA"><title>Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</title></titleInfo><name type="personal"><namePart type="given">Lucia</namePart><namePart type="family">Torracca</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Evasio</namePart><namePart type="family">Pasini</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Salvatore</namePart><namePart type="family">Curello</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claudio</namePart><namePart type="family">Ceconi</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Giuseppe</namePart><namePart type="family">Coletti</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ottavio</namePart><namePart type="family">Alfieri</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roberto</namePart><namePart type="family">Solfrini</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roberto</namePart><namePart type="family">Ferrari</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Divisione di Cardiochirurgia, Spedali Civili, Italy</affiliation><affiliation>Salvatore Maugeri Foundation, IRCCS, Cardiovascular Pathophysiology Research Centre, Gussago, Italy</affiliation><affiliation>Cattedra di Cardiologia, Università degli Studi di Brescia, Italy</affiliation><affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</affiliation><affiliation>Address reprint requests to Dr Ferrari, Cattedra di Cardiologia, Università degli Studi di Brescia, c/o Spedali Civili, P.le Spedali Civili, 1, 25123 Brescia, Italy</affiliation><affiliation>E-mail: ferrari@master.cci.unibs.it</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1996</dateIssued><dateValid encoding="w3cdtf">1996-05-30</dateValid><copyrightDate encoding="w3cdtf">1996</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Background.The aim of this study was to compare the protective effects of continuous warm blood cardioplegia (CWBC) and intermittent warm blood cardioplegia (IWBC) in an experimental model of blood-perfused, isolated rabbit heart.Methods.In the CWBC group, cardiac arrest was induced by continuous infusion of blood cardioplegia (10 mEq/L KCI) followed by 30 minutes of reperfusion with blood. In the IWBC group, after 5 minutes of perfusion with blood cardioplegia (10 mEq/L KCl), coronary flow was abolished for 10 minutes, followed by reperfusion with blood cardioplegia for 5 minutes. This sequence was repeated three times for a total period of 45 minutes. Finally the hearts were reperfused for 30 minutes with blood.Results.Infusion of potassium induced a marked increase in coronary perfusion pressure (from 50 ± 3 to 98 ± 1 mm Hg; p < 0.01), which remained elevated throughout in the CWBC group, whereas in the IWBC group, it dropped to 0 during each no-flow period. In both groups, cardioplegia resulted in a significant reduction in oxygen consumption (from 5.5 ± 0.2 to 0.6 ± 0.03 mL O2 · min−1 · 100 g−1 wet wt; p < 0.01). During CWBC, glucose extraction was significantly reduced (from 152 ± 10 to 64 ± 18 μg · min−1 · g−1 wet wt; p < 0.01). Free fatty acid uptake and creatine kinase and lactate release were not affected. During IWBC, in contrast, a transient but significant release of creatine kinase (from 643 ± 254 to 2,234 ± 296 mU · min−1 · g−1 wet wt; p < 0.01) and lactate (from 63 ± 22 to 374 ± 32 μg · min−1 wet wt; p < 0.01) occurred after each period of ischemia. Despite these metabolic differences, both cardioplegic procedures allowed a prompt and complete recovery of mechanical function and tissue content of high-energy phosphates.Conclusions.Both CWBC and IWBC exert optimal protection in the isolated blood perfused rabbit heart. Thus, IWBC can be safely used to improve visualization of the surgical field.</abstract><note>This study was supported by the target project G179038C FATMA of the National Council of Research (CNR), Rome, Italy.</note><note type="content">Section title: Original article: Cardiovascular</note><relatedItem type="host"><titleInfo><title>The Annals of Thoracic Surgery</title></titleInfo><titleInfo type="abbreviated"><title>ATS</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">199610</dateIssued></originInfo><identifier type="ISSN">0003-4975</identifier><identifier type="PII">S0003-4975(00)X0224-X</identifier><part><date>199610</date><detail type="volume"><number>62</number><caption>vol.</caption></detail><detail type="issue"><number>4</number><caption>no.</caption></detail><extent unit="issue pages"><start>957</start><end>1252</end></extent><extent unit="pages"><start>1172</start><end>1179</end></extent></part></relatedItem><identifier type="istex">8C01E83916A3B4556425FCC51D981C54CB81E6D0</identifier><identifier type="DOI">10.1016/0003-4975(96)00598-X</identifier><identifier type="PII">0003-4975(96)00598-X</identifier><identifier type="ArticleID">9600598X</identifier><accessCondition type="use and reproduction" contentType="">© 1996The Society of Thoracic Surgeons</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>The Society of Thoracic Surgeons, ©1996</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/8C01E83916A3B4556425FCC51D981C54CB81E6D0/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">CARDIAC & CARDIOVASCULAR SYSTEMS</classCode><classCode scheme="WOS">RESPIRATORY SYSTEM</classCode><classCode scheme="WOS">SURGERY</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments></istex></record>Pour manipuler ce document sous Unix (Dilib)
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