Our Summary
This research paper investigates the effectiveness of two different solutions used during heart surgery to stop the heart (cardioplegia). These solutions are Lactated Ringer-based del Nido cardioplegia and cold blood cardioplegia. The study involved 116 patients with congenital heart disease who underwent surgery between September 2018 and November 2020.
The patients were divided into two groups: one group was treated with the del Nido solution (66 patients) and the other with the cold blood solution (50 patients). The researchers compared the patients’ profiles, operation details, death rates, length of care, use of heart-stimulating drugs (inotropes), blood transfusions, and complications.
The study found that the two groups were similar in terms of age, size, and gender. More patients in the del Nido group had a higher risk score (according to the Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery), and four patients in this group died, while none in the cold blood group did. However, the difference in death rates was not statistically significant.
The researchers found no significant difference between the two groups in terms of how long the patients were intubated (had a tube in their throat to help them breathe), how long they stayed in the intensive care unit, and the use of vasoactive medications (drugs that affect blood pressure) after the operation. The del Nido group required 70 to 100 ml less blood transfusion, and the complications were similar in both groups.
In conclusion, the study found that the outcomes of using the Lactated Ringer-based del Nido cardioplegia were similar to those of using the cold blood cardioplegia in congenital heart surgery.
FAQs
- What is the difference between the lactated Ringer-based del Nido cardioplegia and the cold blood cardioplegia?
- Are there any significant differences in the outcomes of using either method for congenital cardiac surgery?
- What are the benefits of using the del Nido cardioplegia solution in congenital cardiac surgery?
Doctor’s Tip
A helpful tip a doctor might tell a patient about cardiac surgery is to follow post-operative instructions closely, including taking medications as prescribed, attending follow-up appointments, and participating in cardiac rehabilitation if recommended. It is also important to maintain a healthy lifestyle with regular exercise, a balanced diet, and avoiding smoking to promote optimal recovery and long-term heart health.
Suitable For
Patients with congenital heart disease undergoing cardiac surgery are typically recommended for cardiac surgery. This study specifically looked at patients with a Society of Thoracic Surgeons-European Association for Cardio-Thoracic Surgery score of 3 to 5, indicating a moderate to high risk for operative mortality. These patients may benefit from the use of lactated Ringer-based del Nido cardioplegia as it was found to have comparable clinical outcomes to cold blood cardioplegia in this study. It is important for patients to be assessed individually by their healthcare providers to determine the most appropriate treatment plan for their specific condition.
Timeline
Before cardiac surgery: The patient undergoes preoperative testing and evaluation to assess their overall health and readiness for surgery. This may include blood tests, imaging studies, and consultation with various medical specialists. The patient may also receive instructions on how to prepare for surgery, such as fasting before the procedure.
Day of surgery: The patient is admitted to the hospital and prepared for surgery. Anesthesia is administered, and the surgical team begins the procedure. In congenital cardiac surgery, the patient may receive either lactated Ringer-based del Nido cardioplegia or cold blood cardioplegia as a method of inducing cardiac arrest during the surgery.
After surgery: The patient is transferred to the intensive care unit (ICU) for monitoring and recovery. They may be intubated and placed on a ventilator to assist with breathing. Inotropes and other medications may be administered to support heart function. The patient may also receive blood transfusions if needed. Complications, such as infection or bleeding, are monitored for and treated as necessary.
Postoperative recovery: The patient gradually recovers from surgery, with monitoring of vital signs, blood tests, and imaging studies to assess their progress. Once stable, the patient is transferred to a regular hospital room for further recovery before being discharged home. Follow-up appointments with the surgical team and other medical providers are scheduled to monitor the patient’s ongoing recovery and overall health.
What to Ask Your Doctor
What type of cardioplegia solution will be used during my surgery (lactated Ringer-based del Nido versus cold blood cardioplegia)?
What are the potential risks and benefits associated with using lactated Ringer-based del Nido cardioplegia for congenital cardiac surgery?
How does the use of lactated Ringer-based del Nido cardioplegia compare to traditional cold blood cardioplegia in terms of clinical outcomes and post-operative recovery?
What is the experience and expertise of the surgical team in using lactated Ringer-based del Nido cardioplegia for congenital cardiac surgery?
Are there any specific considerations or precautions that need to be taken if I receive lactated Ringer-based del Nido cardioplegia during my surgery?
How will the choice of cardioplegia solution impact my post-operative care, including the need for blood transfusions, inotropes, and potential complications?
Are there any alternative cardioplegia solutions or techniques that could be considered for my specific case?
What is the expected duration of my hospital stay and recovery process if I receive lactated Ringer-based del Nido cardioplegia during my surgery?
Are there any ongoing research studies or clinical trials investigating the use of lactated Ringer-based del Nido cardioplegia for congenital cardiac surgery that I should be aware of?
Can you provide me with more information about the potential benefits of using lactated Ringer-based del Nido cardioplegia for congenital cardiac surgery, based on the current evidence and research findings?
Reference
Authors: Sithiamnuai P, Tocharoenchok T. Journal: Asian Cardiovasc Thorac Ann. 2022 Jun;30(5):555-560. doi: 10.1177/02184923211048332. Epub 2021 Sep 23. PMID: 34553609