The effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.

Hdl Handle:
http://hdl.handle.net/10147/209062
Title:
The effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.
Authors:
Coleman, E T; Hargrove, M; Mahony, C O; O'Donnell, A; Shorten, G; Aherne, T
Affiliation:
Cardiothoracic Theatre, Cork University Hospital, Ireland. eointc2@eircom.net
Citation:
J Extra Corpor Technol. 2001 Sep;33(3):148-52.
Journal:
The Journal of extra-corporeal technology
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209062
PubMed ID:
11680727
Abstract:
The cannulation method and cardioplegia solution used during cardiopulmonary bypass (CPB) may both influence plasma potassium concentrations ([K+]) and mean arterial blood pressure (MAP). Bi-caval or right atrial cannulation methods are routinely used in conjunction with crystalloid or blood cardioplegia. We investigated the influence of cannulation method and cardioplegia solutions on plasma [K+] and MAP during cardiopulmonary bypass. Sixty consecutive patients undergoing elective coronary artery bypass grafting (CABG) using CPB were studied. They were randomly divided into three groups of 20 patients. Patients in Group A underwent bi-caval venous cannulation and received crystalloid cardioplegia. Group B patients underwent right atrial cannulation and received crystalloid cardioplegia. Group C patients underwent right atrial cannulation and received blood cardioplegia. In each case. cardioplegia was administered antegrade via the aortic root. Plasma [K+], MAP. and hemoglobin concentration (Hb) were measured over an 8-min period following cardioplegia administration (pilot studies indicated pressure changes occuring post cardioplegia administration up to this time). The combination of bi-caval cannulation and crystalloid cardioplegia (Group A) was associated with the least increase in plasma [K+] and no decrease in MAP. The maximum [K+] for this Group was 4.2 mmol/L (4.6% increase). The minimum mean pressure was 57 mmHg (13.6% increase). Both right atrial cannulation groups (B and C) showed a large rise in plasma [K+] and a decrease in MAP. Group B maximum [K+] was 5.2 mmol/L (27.5% increase). Group C was also 5.2 mmol/L (26.0% increase). Group C showed the largest pressure decrease, the minimum mean pressure was 45 mmHg (21.3% decrease). The Group B minimum mean pressure was 45 mmHg (8.7% decrease). Our results show that patients undergoing CPB operations who are deemed to be at increased risk of suffering adverse effects from hypotensive episodes may benefit from bicaval cannulation and caval snaring, in preference to right atrial cannulation. Crystalloid cardioplegia may be preferable to blood cardioplegia in these cases to maintain the MAP.
Language:
eng
MeSH:
Arteries; Blood Pressure; Cardioplegic Solutions/*classification; *Cardiopulmonary Bypass; Catheterization/adverse effects/*methods; *Heart Arrest, Induced/adverse effects/*methods; Hemoglobins/analysis; Humans; Plasma; Potassium/*blood
ISSN:
0022-1058 (Print); 0022-1058 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorColeman, E Ten_GB
dc.contributor.authorHargrove, Men_GB
dc.contributor.authorMahony, C Oen_GB
dc.contributor.authorO'Donnell, Aen_GB
dc.contributor.authorShorten, Gen_GB
dc.contributor.authorAherne, Ten_GB
dc.date.accessioned2012-02-03T15:11:14Z-
dc.date.available2012-02-03T15:11:14Z-
dc.date.issued2012-02-03T15:11:14Z-
dc.identifier.citationJ Extra Corpor Technol. 2001 Sep;33(3):148-52.en_GB
dc.identifier.issn0022-1058 (Print)en_GB
dc.identifier.issn0022-1058 (Linking)en_GB
dc.identifier.pmid11680727en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209062-
dc.description.abstractThe cannulation method and cardioplegia solution used during cardiopulmonary bypass (CPB) may both influence plasma potassium concentrations ([K+]) and mean arterial blood pressure (MAP). Bi-caval or right atrial cannulation methods are routinely used in conjunction with crystalloid or blood cardioplegia. We investigated the influence of cannulation method and cardioplegia solutions on plasma [K+] and MAP during cardiopulmonary bypass. Sixty consecutive patients undergoing elective coronary artery bypass grafting (CABG) using CPB were studied. They were randomly divided into three groups of 20 patients. Patients in Group A underwent bi-caval venous cannulation and received crystalloid cardioplegia. Group B patients underwent right atrial cannulation and received crystalloid cardioplegia. Group C patients underwent right atrial cannulation and received blood cardioplegia. In each case. cardioplegia was administered antegrade via the aortic root. Plasma [K+], MAP. and hemoglobin concentration (Hb) were measured over an 8-min period following cardioplegia administration (pilot studies indicated pressure changes occuring post cardioplegia administration up to this time). The combination of bi-caval cannulation and crystalloid cardioplegia (Group A) was associated with the least increase in plasma [K+] and no decrease in MAP. The maximum [K+] for this Group was 4.2 mmol/L (4.6% increase). The minimum mean pressure was 57 mmHg (13.6% increase). Both right atrial cannulation groups (B and C) showed a large rise in plasma [K+] and a decrease in MAP. Group B maximum [K+] was 5.2 mmol/L (27.5% increase). Group C was also 5.2 mmol/L (26.0% increase). Group C showed the largest pressure decrease, the minimum mean pressure was 45 mmHg (21.3% decrease). The Group B minimum mean pressure was 45 mmHg (8.7% decrease). Our results show that patients undergoing CPB operations who are deemed to be at increased risk of suffering adverse effects from hypotensive episodes may benefit from bicaval cannulation and caval snaring, in preference to right atrial cannulation. Crystalloid cardioplegia may be preferable to blood cardioplegia in these cases to maintain the MAP.en_GB
dc.language.isoengen_GB
dc.subject.meshArteriesen_GB
dc.subject.meshBlood Pressureen_GB
dc.subject.meshCardioplegic Solutions/*classificationen_GB
dc.subject.mesh*Cardiopulmonary Bypassen_GB
dc.subject.meshCatheterization/adverse effects/*methodsen_GB
dc.subject.mesh*Heart Arrest, Induced/adverse effects/*methodsen_GB
dc.subject.meshHemoglobins/analysisen_GB
dc.subject.meshHumansen_GB
dc.subject.meshPlasmaen_GB
dc.subject.meshPotassium/*blooden_GB
dc.titleThe effects of venous cannulation technique and cardioplegia type on plasma potassium concentration and arterial blood pressure during cardiopulmonary bypass.en_GB
dc.contributor.departmentCardiothoracic Theatre, Cork University Hospital, Ireland. eointc2@eircom.neten_GB
dc.identifier.journalThe Journal of extra-corporeal technologyen_GB
dc.description.provinceMunster-
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