Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0009443 (cold)
 92,137 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Commencing in September 1991, 30 consecutive patients who underwent coronary artery bypass grafting were operated on employing continuous normothermic blood cardioplegia (Group 1). 2.83 +/- 0.81 distal anastomoses per patient were performed. The next 30 consecutive patients were operated on employing intermittent cold crystalloid cardioplegia (Group 2). 2.72 +/- 0.95 distal anastomoses per patient were performed in this group. Cross clamping and cardiopulmonary bypass times were similar in both groups. Electromechanical activity beginning time (69.00 +/- 94.04 sec. versus 101.50 +/- 78.26 sec., p < 0.001) and QRS recovery time (10.92 +/- 8.35 min. verus 19.60 +/- 33.65 min., p < 0.05) were significantly shorter in Group 1 than in Group 2. Maximal potassium levels during cardiopulmonary bypass and in the postoperative period did not significantly differ between the groups. Postoperative serum CPK-MB values were similar. Three patients in Group 1 and four in Group 2 needed IABP support in the early postoperative period. In Group 1, one and in Group 2 three patients suffered perioperative myocardial infarction (difference not significant). Postoperative cardiac index augmentation was significantly higher in Group 1 than in Group 2 (from 2.40 +/- 0.57 L/min/m2 to 3.04 +/- 0.60 L/min/m2 in Gr I, from 2.39 +/- 0.64 L/min/m2 to 2.86 +/- 0.49 L/min/m2 in Gr II, p < 0.01). Coronary sinus oxygen saturations during aortic cross-clamping were significantly higher in Group 1 (53.32 +/- 12.18% versus 17.82 +/- 2.75%, p < 0.001). There were no rhythm disturbances in Group 1 (0%) but atrial fibrillation occurred in 5 (16.66%) cases of the hypothermic group in the postoperative period. In Group 1, two patients, and in Group 2, three patients (difference is not significant) were lost in the early postoperative period. We can say that continuous normothermic blood cardioplegia is a safe alternative way of myocardial protection with good clinical results despite its discomfortable and complicated delivery technique.
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PMID:Is continuous normothermic blood cardioplegia really a practical way of myocardial preservation? Comparison with intermittent cold crystalloid cardioplegia. 830 96

A 64-year-old man was admitted to our hospital with complaints of chest pain on Sep. 26, 1991. ECG revealed myocardial infarction-like ST-elevation in II, III, aVF, V4, V5, and V6 but coronary angiography revealed no abnormal findings in the right and left coronary arteries, and no elevation of SGOT, LDH or CPK was found. Chest CT scan, UCG and chest MRI revealed a tumor invading into myocardium in the left cardiophrenic angle. Myocardial scintigraphy revealed a cold area in the inferior wall. Histologically, the tumor was squamous cell cancer. In spite of treatment, the patient died due to heart failure on Feb. 8, 1992. Myocardial metastasis showing a myocardial infarction-like ECG has been rarely reported.
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PMID:[A case of lung cancer with myocardial metastasis with ECG suggestive of myocardial infarction]. 833 49

Blood cardioplegia (BCP) has been reported as a superior method of myocardial protection, because of its oxygenating and buffering potential, but it is unknown which temperature is most effective. This study was performed to investigate the efficacy of continuous warm blood cardioplegia (CWBCP) versus continuous cold blood cardioplegia (CCBCP) in regard to metabolism, serum enzyme release, cardiac function and edema. Fourteen adult mongrel dogs were subjected to total cardiopulmonary bypass and cross-clamp of the aorta for 120 minutes, and followed by 60 minutes' reperfusion. The dogs were divided into two groups according to the differences of BCP temperature: Group W, 33 degrees C warm BCP, and Group C, 16 degrees C cold BCP with topical cooling. Myocardial oxygen extraction during aortic cross-clamping was significantly higher in group W than in group C. Changes in excess lactate (delta XL) and redox potential (delta Eh) of lactate and pyruvate showed that aerobic metabolism could be maintained in group W and could not in group C. Lipid peroxides (LPO) were measured in coronary artery and sinus blood at the same time, so generations of LPO (A-Cs difference) at 5 minutes after reperfusion were significantly lower in group C than in group W (-0.140 +/- 0.125 nmol/ml V.S. 0.019 +/- 0.093). The incidence of ventricular fibrillation after reperfusion was significantly lower in group W than in group C (1/7 V.S. 7/7). CPK-MB and HBDH releases were significantly lower in group W than in group C during aortic clamp and 60 minutes' reperfusion (47 +/- 15 IU/l, 138 +/- 72 V.S. 94 +/- 24, 229 +/- 71).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A comaprative study of continuous warm blood cardioplegia]. 837 85

The aim of this study is to investigate the efficacy of HTK solution in the 120 minutes cross-clamping method in comparison with conventional intermittent cardioplegia using GIK solution. Fifty-four open heart surgery were performed with cardioplegic solution using either HTK solution (HTK) or GIK solution (GIK). In the HTK, HTK (3L) was infused for the initial dose and 1L was added every 60 min after 120 min of cross-clamping. In GIK, 1L of GIK solution was intermittently infused initially and then every 30 min together with continuous cold blood perfusion. The effect of two cardioplegic solution was evaluated by postoperative cardiac function (CI, %SF), released enzymes (CPK), histology and dosage of catecholamine. Postoperative CI was 3.67 +/- 0.76 in HTK, and 4.34 +/- 1.04 in GIK (NS). % SF was 26.0 +/- 5.26 in HTK and 25.6 +/- 0.76 in HTK, and 4.34 +/- 1.04 in GIK (NS). %SF was 26.0 +/- 5.26 in HTK and 25.6 +/- 9.2 in GIK (NS). The CK-MB (IU/dl) level after reperfusion was significantly decreased in HTK at 60 and 180 min after reperfusion. Histology at 60 min of ischemia revealed a significant increase of edema of mitochondria in GIK. Postoperative catecholamine dose was 2.65 +/- 1.3 in HTK and 10.3 +/- 3.4 in GIK (p < -0.01). PH of myocardium was well maintained around 7.4 during cross-clamping in HTK, however, it was decreased in GIK. In conclusion, The HTK method offers a reliable cardiac protection due to effective buffering using Histidine in comparison with GIK.
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PMID:[Efficacy of myocardial preservation using HTK solution in continuous 120 min cross-clamping method--a comparative study with GIK method]. 840 3

This study explored the effect of recombinant human superoxide dismutase (rh-SOD) for the prevention of reperfusion injury and the myocardial protection in open heart surgery. Fifty one patients undergoing cardiac valve replacements were divided into the following four groups; group I (n = 14), 50 ml of saline was administered through the aortic root into the coronary artery a few minutes prior to reperfusion; group II (n = 14), rh-SOD (10000 U/kg) was administered as the same manner as the group I; group III (n = 13), rh-SOD (10000 U/kg) was administered into the cardiopulmonary circuit a few minutes prior to reperfusion; group IV (n = 10), rh-SOD (3000 U/kg) was administered as the same manner as the group III. They received continuous perfusion of cold blood and GIK solution every 30 minutes. Arterial blood samplings for Creatine phosphokinase MBisozyme (CPK-MB), alpha-hydroxy lactic acid dehydrogenase (HBDH), thiobarbituric acid reactive substance (TBA) were measured up to 24 hours after the reperfusion. CPK-MB values at 12 and 24 hours after reperfusion, and HBDH value at 12 hours after the reperfusion in group II were significantly lower than those in group I. CPK-MB and HBDH levels in group III were lower than group I without statistically significant differences. TBA levels in group II at 9 and 12 hours after the reperfusion were lower than these in group I. TBA levels were not statistically different in group I, III and IV. These results suggest that administration of rh-SOD at the time of reperfusion may be required to prevent reperfusion injury in open heart surgery.
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PMID:[A clinical trial of recombinant human superoxide dismutase for myocardial protection]. 847 90

Post-ischemic reperfusion phenomenon has been studied in two methods of myocardial protection: a crystalloid cardioplegia (St Thomas no.2) and a cold blood cardioplegia (Buckberg) during cardiopulmonary bypass for myocardial revascularisation in patients. Myocardial protection has been assessed from the evolution of hemodynamic parameters, reperfusion arrhythmias and biochemical analysis of the coronary flow after cross-clamp removal: creatinine phosphokinase (CPK_MB) and nucleotide adenine metabolites (adenosine, inosine, hypoxanthine, xanthine and uric acid). The study was performed in two groups of 14 patients. Hemodynamic conditions were similar in both groups during reperfusion in order to avoid different coronary flow. In those conditions, myocardial protection by cold blood cardioplegia reduced reperfusion arrhythmias, and resulted in a loss of CPK-MB release. Furthermore, the reduction of metabolites release, purine bases and oxypurine bases into coronary sinus after cold blood cardioplegia suggest a better protection of myocardial high energy phosphates in this group than after crystalloid cardioplegia. Our results also show that hypoxanthine is probably the final product of ATP degradation in human myocardial tissue.
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PMID:Crystalloid versus cold blood cardioplegia in patients operated on for myocardial revascularisation. 860 7

Post-ischemic reperfusion phenomena were studied in two methods of myocardial protection: crystalloid cardioplegia (St Thomas n(o) 2) and cold blood cardioplegia (Buckherg) during cardiopulmonary bypass for human myocardial revascularisation. Myocardial protection was assessed on the course of hemodynamic parameters, reperfusion arrhythmias and biochemical analysis of the coronary flow after cross-clamp removal: creatine phosphokinase (CPK-MB) and nucleotide adenine metabolites (adenosine, inosine, hypoxanthine, xanthine and uric acid). The study was performed in two groups of 14 patients. Hemodynamic conditions were similar in both groups during reperfusion in order to avoid different coronary flow. Under these conditions, myocardial protection by cold blood cardioplegia reduced reperfusion arrhythmias, and resulted in a loss of CPK-MB release. Furthermore, cold blood cardioplegia provided protection of myocardial energy metabolism by reducing the loss of metabolites, purine bases and oxypurine bases into the coronary sinus. Our results also show that hypoxanthine is probably the final product of ATP degradation in human myocardial tissue.
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PMID:[A study of the 30 minutes following reperfusion after crystalloid and cold blood cardioplegia by enzymatic and metabolic analysis of coronary blood flow]. 876 Nov 9

Great advances in surgical techniques, perfusion technology and cardiac anesthesia have made heart surgery safer. However, the mayor advance over the past 15 years has been in the field of myocardial protection. Much remains to be done in this field and there is not complete agreement about the different methods of myocardial protection. At the Institute of Cardiac Surgery of Parma a research is developing to concern three different cardioprotective strategies, of which preliminary results are showing. Three groups of patients with the same clinical, surgical, anesthesiological features, who underwent cardiac surgery have been selected. In patients of group A intermittent cold hyperkalemic crystalloid cardioplegia has been used, in those of group B intermittent cold blood cardioplegia and in those of group C intermittent cold blood cardiolegia associated a warm glucose blood cardioplegic reperfusion before aortic unclamping. In all patients enzyme levels (CPK; CPK-MB; LHD; SGOT; SGPT) were measured 12, 24, 72, 120 hours postoperatively; data were collected, also, on spontaneous return to sinus rhythm, perioperative myocardial infarction and the need or not for inotropic agents. All data at first and then those of patients who underwent only coronary rivascularization (75% of patients) were statistically analyzed (one-way Fischer's test). It appears that the use of antegrade cold intermittent blood cardioplegia with reperfusion is more optimal for myocardial protection, how show lower levels of CPK-MB especially in the first postoperative period. In group C remains greater spontaneous resumption of normal sinus rhythm compare to group A and this suggests a best preservation of cellula-integrity and function with use of blood cardioplegia.
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PMID:[Myocardial protection during extracorporeal circulation. Preliminary results with different techniques]. 892 83

Isolated stenosis of the aortic valve leads to left ventricular hypertrophy which makes myocardial protection difficult during cardiac, surgery and the choice of optimal cardioplegia remains controversial. The authors compared three protocols of cardioplegia in patients operated for isolated aortic stenosis with left ventricular hypertrophy. Sixty consecutive patients with these criteria were randomly attributed to one of the three following groups (20 in each group): cardioplegia with continuous warm blood; cardioplegia with intermittent cold blood with warm reperfusion; cardioplegia with intermittent cristalloid using SLF11 solution. The preoperative data was comparable in three groups. There were no deaths. Patients undergoing cardioplegia with warm blood came off cardio-pulmonary bypass more quickly (15 mn vs 21 mn for the other groups, p = 0.03). Cristalloid cardioplegia was associated with major acidosis in coronary sinus blood when the aorta was declamped (7.11 vs 7.38 for cardioplegia with cold blood and 7.39 for cardioplegia with warm blood, p < 0.0001) but with a low postoperative CPK-MB rise. Cardioplegia with cold blood induced higher CPK-MB liberation than the other forms of cardioplegia (at H-, 63 mcg/L vs 33 for warm blood and 45 for cristalloid cardioplegia, p = 0.0019). None of the protocols tested prevented myocardial lactate production at aortic declamping. Cardioplegia with warm blood offers therefore the best protection for hypertrophied myocardium during simple aortic valve replacement but it does not maintain strictly aerobic metabolism.
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PMID:[What myocardial protection to select for isolated aortic valve replacement? A clinical prospective study of 3 cases of cardioplegia]. 923 72

Blood cardioplegia has recently been advocated as a superior method of myocardial protection, but its temperature is important, and it has not been compared to a magnesium containing crystalloid cardioplegia. This study was undertaken to compare the protective effect of cold blood cardioplegia (BCP) and cold crystalloid cardioplegia with or without magnesium (MgKCP and KCP). Fourty-five patients were undertaken prosthetic cardiac valve replacement with left ventricular volume overload from valvular regurgitation. They were divided into three groups for the difference of the cardioplegic solution. Intraoperatively, myocardial temperature and the tissue PCO2 was monitored, and the content of calcium and magnesium of right atrium was measured before and after aortic cross clamping. Postoperatively, left ventricular stroke work index and serum CPK-MB isozyme activity were measured at 3, 6, 24 and 48 hours after weaning from cardiopulmonary bypass. The increase of the tissue PCO2 during aortic cross clamping and its recovery at ten minutes after reperfusion were significantly suppressed in BCP. The retension of the tissue calcium after reperfusion and calcium to magnesium ratio were significantly low in MgKCP. The recovery of cardiac pump function and decrease of CPK-MB were superior in MgKCP.
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PMID:[Comparison of cold blood cardioplegia and cold crystalloid cardioplegia with or without magnesium]. 930 15


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