J.Jpn. Surg. Soc.. 93(6): 632-638, 1992

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Original article

CLINICAL EVALUATION OF MYOCARDIAL PROTECTION BY OXYGENATED CRYSTALLOID CARDIOPLEGIC SOLUTIONS WITH DBcAMP

Possible enhancement of myocardial protection by adding DBcAMP and oxygenation of a crystalloid cardioplegic solution（CCS）was evaluated in a three group study. The patients having coronary bypass operation or valvular operation were divided into three groups,each consisting of 15 patients,and differing only in the type of CCS employed. Group I was protected by nonoxygenated CCS（PO₂ 190mmHg, PCO₂, 32mmHg, pH 7.78, K 30mmEq/L）, Group II by adding DBcAMP to nonoxygenated CCS and Group III by adding DBcAMP to oxygenated CCS（PO₂ 790mmHg, PCO₂ 26mmHg, pH 7.87）. Group III had significantly improved CI and double product（p＜0.05） compared with Group II. However, CPK, CPK-MB, and myoglobin in the serum were similar in each group.
Lactate and pyluvate ratio（L/P）in the coronary sinus bloods were improved to lower value after the pump than before the pump only in Group III. Base excess in the coronary sinus held on alkalosis after aortic declamp only in Group III. The refunction time was significantly shortest with Group III than with other groups（p＜0.01,0.05） and Group II was significantly shorter than Group I（p＜0.05）. It is concluded that oxygenation and adding DBcAMP to CCS are effectual for the myocardial metabolism and protect the myocardial damage during cardiac arrest.

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