| Part OneMyocardial Protection of Warm Blood Cardioplegic Induction duringCardiopulmonary Bypass[This original paper was published on: J Extra Corpor Technol, 2001; 33 (2): 106-110. ]In this prospective randomized clinical study, we evaluated the myocardial protection of warm blood cardioplegic induction and cold blood cardioplegic induction, respectively, during cardiopulmonary bypass.Methods: Twenty-eight adult patients underwent valve replacement were randomly divided into two groups: group T (14 cases) received cold (6-8°C) blood cardioplegia after ECG showed straight line induced by warm (35-37°C) blood cardioplegia; whereas group C (14 cases) received cold blood cardioplegic induction only. The effects of myocardial protection of both cardioplegic inductions were evaluated by clinical outcomes, myocardial biochemistry index (cardiac troponin T, cTnT), and myocardial morphology.Results: (1) Clinical outcomes — The ratio of myocardial auto-resuscitation in group T (93%) was significantly higher than that in group C (50%). Only one case in group T (7%) and three cases in group C (21%) needed temporary pacemakers. No case in group T (0%) and five cases (36%) in group C received inotropic support. The postoperative mechanical ventilation time and ICU stay time of group T were obviously shorter than those of group C. (2) Myocardial biochemistry index — plasma level of cTnT in group T was obviously lower than that of group C immediately and 6 h after cardiopulmonary bypass. (3) Myocardial morphology — group T had comparably better outcomes than group C.Conclusion: Warm blood cardioplegic induction during cardiopulmonary bypass, compared with cold blood cardioplegic induction, provides better myocardial protection.
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