Normothermic cardiopulmonary bypass and cardioplegia reduce inotropic requirements and creatine kinase-MB after coronary artery bypass graft surgery

Mitsuru Kunihiro; Tsutomu Shimabukuro; Toshiaki Horie; Koichiro Nandate; Kazuyoshi Ishida; Katsuhiro Seo; Hiroshi Takeshita

doi:10.1007/BF02480742

Normothermic cardiopulmonary bypass and cardioplegia reduce inotropic requirements and creatine kinase-MB after coronary artery bypass graft surgery

J Anesth. 1997 Dec;11(4):265-269. doi: 10.1007/BF02480742.

Authors

Mitsuru Kunihiro^{1

2}, Tsutomu Shimabukuro^{1

2}, Toshiaki Horie^{1

2}, Koichiro Nandate^{1

2}, Kazuyoshi Ishida^{1

2}, Katsuhiro Seo^{1

2}, Hiroshi Takeshita^{1

2}

Affiliations

¹ Department of Anesthesiology, Kokura Memorial Hospital, 1-1 Kifune-Machi, Kokurakita-ku, 802, Kitakyushu, Japan.
² Department of Intensive Care Medicine, Kokura Memorial Hospital, 1-1 Kifune-Machi, Kokurakita-ku, 802, Kitakyushu, Japan.

PMID: 28921064
DOI: 10.1007/BF02480742

Abstract

Purpose: To determine whether normothermic cardiopulmonary bypass (CPB) and cardioplegia preserve myocardial function, reduce inotropic requirements, and reduce markers of myocardial ischemia following coronary artery bypass graft surgery (CABG).

Methods: We retrospectively reviewed the charts of 171 consecutive patients undergoing elective CABG by a single surgeon from April 1994 to December 1995. Hypothermic CPB with intermittent cold cardioplegia was used in 83 patients and normothermic CPB with intermittent warm cardioplegia in 88 patients. Demographic, surgical, hemodynamic, and inotropic requirements and laboratory data were reviewed.

Results: The duration of CPB was significantly shorter in the normothermic group (113±27vs 90±21 min;P<0.0001). After CPB the cardiac index was similar between groups, but significantly larger doses of both dopamine and dobutamine were required (8vs 5μg·kg^-1·min^-1,P<0.0001), and significantly more patients required norepinephrine administration in the hypothermic group (18%vs 6%;P=0.01). Postoperative peak values of creatine kinase MB fraction (CK-MB) were significantly lower in the normothermic group (80±60vs 55±54 IU·I^-1;P<0.0001).

Conclusion: Normothermic CPB and cardioplegia reduce inotropic requirements and CK-MB following CABG.

Keywords: Cardioplegia; Cardiopulmonary bypass; Normothermia.