B . Ali et al .: J Extra Corpor Technol 2024 , 56 , 84 – 93 89
Table 2 . Demographic and clinical characteristics .
|
Control Group ( rdNC ) |
Group A ( rldNCS ) |
Group B ( prdNCS ) |
p-Value |
|
n = 40 |
n = 40 |
n = 40 |
|
Age ( y ) |
63 ± 6.1 |
61 ± 10.1 |
62 ± 8.7 |
0.454 |
Male |
25 ( 62.5 ) |
22 ( 55 ) |
25 ( 62.5 ) |
0.732 |
BMI ( kg / m 2 ) |
26.09 ± 4.30 |
25.90 ± 4.33 |
25.35 ± 3.67 |
0.732 |
HTN |
25 ( 62.5 ) |
31 ( 77.5 ) |
25 ( 62.5 ) |
0.225 |
DM |
19 ( 47.5 ) |
17 ( 42.5 ) |
19 ( 47.5 ) |
0.874 |
DM on insulin |
6 ( 15 ) |
7 ( 17.5 ) |
6 ( 15 ) |
0.939 |
HLP |
21 ( 52.5 ) |
15 ( 37.5 ) |
17 ( 42.5 ) |
0.388 |
COPD |
0 ( 0 ) |
2 ( 5 ) |
0 ( 0 ) |
0.328 |
Asthma |
3 ( 7.5 ) |
2 ( 5 ) |
3 ( 7.5 ) |
> 0.999 |
P . HTN |
2 ( 5 ) |
2 ( 5 ) |
1 ( 2.5 ) |
> 0.999 |
C . St (> 50 %) |
6 ( 15 ) |
7 ( 17.5 ) |
14 ( 35 ) |
0.066 |
CCS Class 4 |
3 ( 7.5 ) |
6 ( 15 ) |
6 ( 15 ) |
0.504 |
Angina NYHA |
|
|
|
0.309 |
Class I |
14 ( 35 ) |
11 ( 27.5 ) |
12 ( 30 ) |
|
Class II |
17 ( 42.5 ) |
12 ( 30 ) |
9 ( 25.5 ) |
|
Class III |
7 ( 17.5 ) |
12 ( 30 ) |
13 ( 22.3 ) |
|
Class IV |
2 ( 5 ) |
4 ( 10 ) |
6 ( 13 ) |
|
EF (%) |
50 ( 45 – 55 ) |
45 ( 40 – 55 ) |
47.5 ( 40 – 55 ) |
0.594 |
Euro SCORE II (%) |
|
|
|
0.289 |
Low risk < 4 |
39 ( 97.5 ) |
37 ( 92.5 ) |
34 ( 85 ) |
|
Intermediate risk 4 – 8 |
1 ( 25 ) |
2 ( 5 ) |
5 ( 12.5 ) |
|
High risk > 8 |
0 ( 0 ) |
1 ( 2.5 ) |
1 ( 2.5 ) |
|
Frequency with percentage = N (%), Mean ± SD and Median ( Q1 – Q3 ), BMI ( Body Mass Index ), HTN ( Hypertension ), DM ( Diabetes Mellitus ), HLP ( Hyperlipidemia ), COPD ( Chronic Obstructive Pulmonary Disease ), P . HTN ( Pulmonary Hypertension ), C . St ( Carotid Stenosis ), CCS ( Canadian Cardiovascular Society ), NYHA ( New York Heart Association ), EF ( Ejection Fraction ).
differences were observed for lactate levels within groups based on time interaction and groups based on test values ( p = 0.064 and p = 0.129 , respectively ). However , there was a significant difference among groups based on time effect ( p < 0.001 ) and lactate level was high in the control group compared to the Ringer-based del Nido cardioplegia group ( p = 0.010 ). Despite this , the time difference in lactate levels among groups was within the normal range , so the difference based on time interaction in lactate levels among groups did not support or reject the hypothesis . See Figure 2 for primary outcomes .
Secondary outcomes
Secondarily , Intraoperative bypass time , clamp time , cardioplegia volume and number of cardioplegia doses , postclamp-off ventricular fibrillation needing DC cardioversion , and mortality were observed . Furthermore , postoperative Atrial flutter , Atrial fibrillation , Mechanical Ventilation support , ICU stay and mortality were also observed . The median bypass time for the rdNCS group was 68.5 ( 60 – 80 ), the rldNCS group 68.5 ( 60 – 86.75 ), and the prdNCS group 70 ( 65 – 75.75 ) minutes respectively and there were no significant differences observed among groups ; p = 0.824 . The median clamp time for the rdNCS group was 42.5 ( 35.75 – 47.75 ), the rldNCS group 41.5 ( 38.25 – 54.75 ), and the prdNCS group 44.5 ( 38 – 49.25 ) minutes respectively and there were no significant differences observed among groups ; p = 0.796 . The cardioplegia volume was around 1000 mL and inducted via antegrade in a single dose in each group with no variability . The median number of grafts in the rdNCS group was 4 ( 3.25 – 4 ) the rldNCS group 4 ( 4 – 4 ), and the prdNCS group 4 ( 3 – 4 ) respectively and there were no significant differences observed among groups ; p = 0.536 . However , grafts were not included in the secondary outcomes but to avoid confounding biases we considered the number of grafts as an intraoperative variable too .
In the rdNCS group , 14 ( 35 %) individuals , while in the rldNCS group , 11 ( 27.3 %) individuals , and in the prdNCS group , 12 ( 30 %) individuals were observed with VF needing DC shock cardioversion and there was no significant difference observed among the groups ; p = 0.761 . In the rdNCS group , 2 ( 5 %) individuals , while in the rldNCS group , 3 ( 7.5 %) individuals , and in the prdNCS group , 4 ( 10 %) individuals were observed with AFL postoperatively and there was no significant difference observed among the groups ; p = 0.908 . Similarly , In the rdNCS group , 4 ( 10 %) individuals , while in the rldNCS group , 5 ( 12.5 %) individuals , and in the prdNCS group , 4 ( 10 %) individuals were observed with AF postoperatively and there was no significant difference observed among the groups ; p > 0.999 . The median mechanical ventilation support time for the rdNCS group was 5.7 ( 4.5 – 6.5 ), the rldNCS group 5.5 ( 4.1 – 6.5 ), and the prdNCS group 5.7 ( 4.5 – 7 ) hours respectively and there were no significant differences observed in any of the groups ; p = 0.580 . The median ICU stay for the rdNCS group was 64 ( 43.23 – 85.25 ), the rldNCS group 63.5 ( 40.50 – 75.75 ), and the prdNCS group 52 ( 45.50 – 69.50 ) hours respectively and there were no significant differences observed among