Objective: The objective of this study was to determine the effect, if any, of adenosine blood cardioplegia on blood component usage after heart surgery.
Summary Background Data: The most common cause of nonsurgical postcardiopulmonary bypass bleeding is platelet dysfunction. For this reason, pharmacologic agents are under investigation in an effort to reduce the need for transfusion in this setting.
Methods: A posthoc analysis of blood product usage was performed in data obtained from a Phase I, single center, open label, randomized study performed in 63 patients. The trial was designed to test the safety and tolerance of adenosine when added to blood cardioplegia in increasing doses to enhance myocardial protection. The database provided information regarding the effect of adenosine cardioplegia on venous plasma adenosine concentrations, the amount of platelets, fresh frozen plasma and packed erythrocytes used, and the association between the adenosine dose and postoperative thoracic drainage.
Results: The postoperative thoracic drainage at 6 hours, 24 hours, and at the time of chest tube removal in the high-dose adenosine cardioplegia group was 68%, 76%, and 75% of the placebo and low-dose adenosine cardioplegia group (p < 0.05). The highest dose of adenosine studied increased baseline adenosine venous plasma levels 360-fold, from 0.17 +/- 0.09 mumol/L to 42.30 +/- 11.20 mumol/L (p < 0.05). This marked increase was associated with a 68%, 56%, and 58% reduction in platelet, fresh frozen plasma, and packed erythrocyte usage, respectively (p < 0.05).
Conclusions: In addition to enhancing the heart's tolerance to ischemia, adenosine-supplemented cardioplegic solution also may reduce bleeding after cardiopulmonary bypass.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1235416 | PMC |
| http://dx.doi.org/10.1097/00000658-199610000-00010 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A novel cardioprotective perfusion protocol prevents functional decline during extended normothermic ex situ heart perfusion of marginal porcine hearts.
J Heart Lung Transplant
October 2024
University Medical Center Utrecht, Department of Cardiothoracic Surgery, Division of Heart and Lungs, Utrecht, The Netherlands. Electronic address:
Background: A common limitation to normothermic ex situ heart perfusion (ESHP) is functional decline. We previously designed a cardioprotective normothermic perfusion protocol, incorporating adenosine-lidocaine cardioplegia, subnormothermic reperfusion, pyruvate and methylprednisolone supplementation, and hemofiltration to prevent myocardial functional decline over 4 hours. In this study, we added continuous catecholamine infusion and protective loading conditions to assess the effectiveness of this enhanced cardioprotective perfusion protocol in preventing functional decline during extended normothermic perfusion in marginal porcine hearts.
View Article and Find Full Text PDFThe cardioprotective effects of adenosine-induced cardioplegic arrest versus saline in aortic valve replacement patients: A randomized controlled trial.
Scand J Surg
December 2024
Heart Hospital, Tampere University Hospital, Tampere, Finland.
Article Synopsis
- The study aimed to assess the impact of an adenosine bolus compared to saline during the initial cardioplegia on patient outcomes in aortic valve replacement (AVR) surgeries.
- During the trial, 45 patients were randomized to receive either adenosine or saline, with various cardiac function metrics measured over time.
- The results indicated no significant differences in cardiac index or other secondary outcomes between the two groups, although the left ventricular stroke work index was lower in the adenosine group.
Targeting the I Channel PKA Phosphorylation Axis to Restore Its Function in High-Risk LQT1 Variants.
Circ Res
September 2024
Dr. Neher's Biophysics Laboratory for Innovative Drug Discovery, State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao SAR, China (L.Z., Z.Y., D.J., Y.O., H.Z., X.L., C.X., C.H., B.S., S.K.C., Z.-H.J., E.N., P.H.).
Article Synopsis
- The KCNQ1+KCNE1 potassium channel is vital for heart stress adaptation, where β-adrenergic stimulation enhances its activity via phosphorylation, essential for managing increased heart rates.
- Variants in the KCNQ1 gene can lead to long-QT syndrome type 1 (LQT1), with some mutations making patients more susceptible to serious heart risks, but the details of how phosphorylation affects channel function and cAMP sensitivity are still unclear.
- Research using techniques like patch clamp and induced pluripotent stem cells revealed key molecular features in LQT1 variants and identified a small molecule, ML277, that can restore function in high-risk mutations by targeting the phosphorylation axis of the channel.
N-cyclohexyladenosine is better than meperidine and buspirone at suppressing metabolism during TTM32 but does not improve outcome after cardiac arrest.
Exp Neurol
October 2024
Center for Transformative Research in Metabolism, Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA. Electronic address:
N-clyclohexyladenosine (CHA) is an adenosine A receptor agonist that inhibits thermogenesis. Cardiovascular side effects however, limit use of CHA as a therapeutic. We and others have shown that this can be reversed by administering 8-p-(sulfophenyl)theophylline (8-SPT), a nonspecific antagonist that does not cross the BBB.
View Article and Find Full Text PDFComparison of "Huaxi-1" or "histidine-tryptophan-ketoglutarate" cardioplegia in an animal model.
Front Cardiovasc Med
June 2024
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.
Background: Using a pig model of cardiopulmonary bypass, we compared outcomes after cardioplegia either with our in-house "Huaxi-1" solution containing natural blood and crystalloid or with the entirely crystalloid, commercially available "histidine-tryptophan-ketoglutarate" solution.
Methods: Cardiopulmonary bypass was established in 12 healthy male pigs, who were randomized to receive a single dose of either Huaxi-1 or entirely crystalloid. All animals were then subjected to whole-heart ischemia for 90 min, followed by 2 h of reperfusion, after which myocardial injury was assessed in terms of cardiac function, myocardial pathology and levels of biomarkers in plasma, while levels of high-energy phosphate in myocardium were assayed using liquid chromatography.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!