Study On The Application Of Potassium Chloride Injection In Cardiac Recovery In Patients Undergoing Extracorporeal Circulation Operation

ObjectiveFor patients who need heart surgery,no matter he is congenital heart disease,valvular disease or coronary heart disease（CHD）,the myocardium usually has suffered different degree of damage before the surgery.And anesthesia,cardiopulmonary bypass（CPB）and the trauma of surgery itself also will do damage to the myocardium during the operation.Thus the heart re-beating after the open of ascending aorta and coronary circulation becomes very difficult.So how to reduce the damage has directly effect on the outcomes of operation.Therefore the heart re-beating becomes one of the most important link and main complication during the CPB.At present,the heart re-beating form includes automatic re-beating and re-beating after drug treatment followed by electric defibrillation.This test intends to explore the application of potassium chloride injection during the open of ascending aorta to the recovery of heart beating to find a method to improve the heart re-beating rate of patients undergoing CPB.MethodsForty patients（no gender limitation,age 40-72 years old,On average 58 years old,weigh 56kg⁸2kg,On average 68kg.ASA physical statusⅡ^Ⅲ）who selectively received mitral valve and aortic valve replacement and ventricular fibrillation happened after the open of ascending aorta were enrolled in this clinical trail.Patients were randomly divided into two groups using a random number table:normal saline（NS）（control group,n=20）and potassium chloride injection group（test group,n=20）.In the test group 10ml 10%potassium chloride injection wasintravenous injectionrapidly after the the open of ascending aorta and ventricular fibrillation happened,while in the control group same volume NS was given.The heart reat（HR）,mean arterial pressure（MAP）,central venous pressure（CVP）,cardiac displacement（CO）,peripheral vascular resistance（PVR）were recorded and 5ml arterial blood samples were collected respectively between anesthesia induction and skin incision（T1）,30 minutes after the star of CPB（T2）,5 minutes after theopen of ascending aorta（T3）,5 minutes after the heart re-beating（T4）,5 minutes before the end of CPB（T5）,10 minutes after the end of CPB（T6）and 4hours after the operation（T7）.2ml of the blood samples were used for blood gas analysis and the rest were centrifugalized to separate the plasma and stored in-80℃refrigerator to detect the concentrations of Creatine kinase-MB（CK-MB）.The the auto-rebeat rate of heart of the two groups was recorded.ResultsCompared with T₁,the concentration of hemoglobin（Hb）decreased at T_2-4,the concentration of potassium ion increased at T₅,the concentration of glucose and lactic acid increased at T_6,7,the concentration of CK-MB increased at T_4-7（P<0.05）.The concentration of K⁺in plasma of the test group increased at T_2-7（P<0.05）compared with the control group.Compared with the control group,the auto-rebeat rate of heart raised in the test group（P<0.05）.ConclusionAfter the open ascending aorta showed ventricular fibrillation,the rapid infusion of potassium chloride could quickly remove the tremor and improve the patients’ automatic recurrence rate.