164 N . Kachoueian et al .: J Extra Corpor Technol 2024 , 56 , 159 – 166
Table 3 . Frequency distribution of cardiac enzymes among patients of both groups , LR DN ( modified del Nido ) and PL DN groups ( conventional del Nido solution ), at different measurement points .
Groups |
|
LR DN |
PL DN |
p-value |
Variables |
|
( mean ± SD ) |
( mean ± SD ) |
|
Preoperative |
CPK ( ng / mL ) |
111 ± 117 |
101 ± 187.25 |
0.32 |
|
cTnI ( ng / mL ) |
1.6 ± 4.79 |
1.52 ± 2.68 |
0.81 |
Post-declamp |
CPK ( ng / mL ) |
233 ± 314.85 |
248 ± 112 |
0.71 |
|
cTnI ( ng / mL ) |
1.85 ± 4.22 |
1.92 ± 2.82 |
0.24 |
ICU admission |
CPK ( ng / mL ) |
390 ± 351 |
383.50 ± 160.75 |
0.22 |
|
cTnI ( ng / mL ) |
2.20 ± 3.54 |
2.15 ± 2.60 |
0.005 # |
24 h after ICU admission |
CPK ( ng / mL ) |
437 ± 215 |
270.50 ± 199.25 |
0.18 |
|
cTnI ( ng / mL ) |
2.26 ± 3.90 |
1.79 ± 1.03 |
0.03 |
CPK : creatine phosphokinase , CPK-MB : creatine phosphokinase-MB , LDH : lactate dehydrogenase , cTnI : cardiac troponin I , ICU : intensive care unit , IQR : interquartile range . # There is a significant difference between groups ( p < 0.05 ).
Table 4 . Frequency distribution of blood product usage among patients of both groups , LR DN ( modified del Nido ) and PL DN groups ( conventional del Nido solution ), at different measurement points .
Groups LR DN PL DN p-value Variables N % N %
Operation room
Pack cell |
14 |
24.6 |
12 |
23.1 |
0.856 |
Platelet |
12 |
21.1 |
8 |
15.4 |
0.445 |
FFP |
10 |
17.5 |
12 |
23.1 |
0.47 |
Fibrinogen |
0 |
0 |
1 |
1.9 |
0.293 |
ICU admission |
Pack cell |
8 |
14 |
11 |
21.2 |
0.33 |
|
Platelet |
3 |
5.3 |
5 |
9.6 |
0.384 |
|
FFP |
3 |
5.3 |
2 |
3.8 |
0.724 |
n stands for the frequency of the patients receiving that product in each group and the % for the frequency percent of the patients in each group receiving that product at the corresponding time . ICU : intensive care unit , FFP : fresh frozen plasma .
Table 5 . Values of arterial blood gasses among patients of both groups , LR DN ( modified del Nido ) and PL DN groups ( conventional del Nido solution ), at different measurement points .
Groups |
|
LR DN |
PL DN |
p-value |
Variables |
|
( mean ± SD ) |
( mean ± SD ) |
|
Preoperative |
PaO 2 ( mm Hg ) |
343 ± 251 |
363.50 ± 218.25 |
0.54 |
|
PaCO 2 ( mm Hg ) |
39 ± 2 |
39 ± 2.75 |
0.84 |
|
HCO 3 ( mm Hg ) |
27 ± 4 |
26 ± 34 |
0.81 |
Postoperative |
PaO 2 ( mm Hg ) |
281.50 ± 209.50 |
314 ± 145 |
0.86 |
|
PaCO 2 ( mm Hg ) |
39 ± 8 |
37 ± 5 |
0.15 |
|
HCO 3 ( mm Hg ) |
22 ± 3.75 |
23 ± 2 |
0.21 |
ICU admission |
PaO 2 ( mm Hg ) |
157 ± 99 |
136 ± 70.75 |
0.24 |
|
PaCO 2 ( mm Hg ) |
41 ± 9 |
41 ± 6.50 |
0.45 |
|
HCO 3 ( mm Hg ) |
23 ± 3.50 |
22 ± 4.50 |
0.96 |
ICU : intensive care unit , PaO 2 : partial pressure of oxygen ; PaCO 2 : partial pressure of carbon dioxide ; HCO 3 : bicarbonate , IQR : interquartile range . The fraction of inspired oxygen , FiO2 , was 90 % according to the standard of practice in our setting .
Study limitations
Interpretation of the findings from the current study is limited by the small sample size . Also , the current study follows up on the patients until 24 h after ICU admission . Studies with longer follow-up time , in the ICU and post-discharge from the hospital , may give better insights into the long-term outcomes of using LR as a substitute with PL as a base solution in the DN cardioplegia .
Conclusion
In conclusion , based on the significantly higher serum levels of cTnI and the higher need for inotrope at the postoperative and ICU stay measurement points in patients receiving modified DN solution , We recommend using standard del Nido cardioplegia with a base of Plasma-Lyte A for patients presenting for CABG surgery regarding its better myocardial protection in the present study . Further studies are warranted to