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.
Url:
DOI: 10.1016/0003-4975(96)00598-X
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<author><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name>
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<affiliation><mods:affiliation>Laboratorio Analisi, Opera Pia Paolo Richiedei, Gussago, Brescia, Italy</mods:affiliation>
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<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>
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<author><name sortKey="Coletti, Giuseppe" sort="Coletti, Giuseppe" uniqKey="Coletti G" first="Giuseppe" last="Coletti">Giuseppe Coletti</name>
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<author><name sortKey="Alfieri, Ottavio" sort="Alfieri, Ottavio" uniqKey="Alfieri O" first="Ottavio" last="Alfieri">Ottavio Alfieri</name>
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<author><name sortKey="Ferrari, Roberto" sort="Ferrari, Roberto" uniqKey="Ferrari R" first="Roberto" last="Ferrari">Roberto Ferrari</name>
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<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>
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<affiliation><mods:affiliation>E-mail: ferrari@master.cci.unibs.it</mods:affiliation>
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<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>
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<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>
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<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>
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<json:item><name>Salvatore Curello MD</name>
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<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>
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<json:item><name>Claudio Ceconi</name>
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<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>
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<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>
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<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>
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<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>
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<json:item><name>Roberto Ferrari MD, PhD</name>
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<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>
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<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>
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<title>Methods of enzymatic analysis</title>
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<categories><wos><json:string>CARDIAC & CARDIOVASCULAR SYSTEMS</json:string>
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<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>
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<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>
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<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>
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<ce:copyright type="unknown" year="1996">The Society of Thoracic Surgeons</ce:copyright>
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<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. Thus, IWBC can be safely used to improve visualization of the surgical field.</ce:simple-para>
</ce:abstract-sec>
</ce:abstract>
</head>
<tail view="all"><ce:bibliography view="all" id="bibliography.0010"><ce:section-title>References</ce:section-title>
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<mods version="3.6"><titleInfo lang="en"><title>Continuous versus intermittent warm blood cardioplegia: Functional and energetics changes</title>
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<titleInfo 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>
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</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>
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<originInfo><publisher>ELSEVIER</publisher>
<dateIssued encoding="w3cdtf">1996</dateIssued>
<dateValid encoding="w3cdtf">1996-05-30</dateValid>
<copyrightDate encoding="w3cdtf">1996</copyrightDate>
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<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>
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<originInfo><dateIssued encoding="w3cdtf">199610</dateIssued>
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<identifier type="ISSN">0003-4975</identifier>
<identifier type="PII">S0003-4975(00)X0224-X</identifier>
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<detail type="volume"><number>62</number>
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<identifier type="ArticleID">9600598X</identifier>
<accessCondition type="use and reproduction" contentType="">© 1996The Society of Thoracic Surgeons</accessCondition>
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