Kardiyopulmoner Bypass Sırasında Kan Kardiyoplejisi ve Del Nido Kardiyopleji Solüsyonlarının Kullanımı

Ezhar Ersöz

doi:10.5281/zenodo.13863014

Authors

Ezhar Ersöz

DOI:

https://doi.org/10.5281/zenodo.13863014

Keywords:

Cardiopulmonary Bypass, Myocardial Protection, Del Nido Cardioplegia, Blood Cardioplegia

Abstract

The aim of this study is to provide information about blood cardioplegia solutions (BCS) and del Nido cardioplegia solutions (DNCS) used for myocardial protection during cardiopulmonary bypass (CPB). Maintenance of myocardial viability is critical for successful open heart surgery. Cardioplegia solutions with different compositions are used to provide adequate myocardial protection, but there is no standard for optimal composition and administration technique. DNCS is prepared by mixing 1 unit of blood with 4 units of crystalloid fluid, while BCS is usually prepared by mixing 1 unit of crystalloid with 4 units of blood. DNCS is usually administered as a single dose, while BCS should be repeated every 15-20 minutes. DNCS contains potassium chloride and lidocaine, while BCS has a higher potassium concentration and does not contain calcium. DNCS is effective for procedures with a cross-clamp time of less than 90 minutes, whereas BCS provides longer protection. The advantages of DNCS include time saving, low cost, less blood product use and prolonged protection, while the advantages of CDS include high oxygen carrying capacity and a wide range of applications. On the other hand, the efficacy of DNCS may decrease in prolonged ischaemia, whereas BCS may interrupt the surgical process and increase costs because it requires continuous repetition. In conclusion, although both solutions are effective in myocardial protection, DNCS stands out as a less invasive and cost-effective option. However, it has been reported that in complex procedures requiring prolonged ischaemia, BCS may be more appropriate. The surgeon's preference may vary according to the patient's condition and the characteristics of the surgical procedure.

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