ผลลัพธ์ทางคลินิกของการใช้น้ำยาคาร์ดิโอพลีเจียแบบดั้งเดิมกับ น้ำยาเดลนิโดคาร์ดิโอพลีเจียในผู้ป่วยทำทางเบี่ยงหลอดเลือดหัวใจ: การใช้น้ำยาคาร์ดิโอพลีเจียในผู้ป่วยทำทางเบี่ยงหลอดเลือดหัวใจ

Jirawat  Suwannakit

Authors

Jirawat Suwannakit Pharmaceutical Department, Buddhachinaraj Phitsanulok Hospital 65000

Keywords:

cardioplegia, del Nido cardioplegia, coronary artery bypass grafting, open heart surgery

Abstract

Cardioplegia is a potassium-based solution that stops the heartbeat, allowing cardiac surgeons to perform surgeries more easily and safely. This study aimed to compare clinical outcomes of cardioplegia and del Nido cardioplegia in coronary artery bypass grafting patients. This study was a retrospective study using random sequencing. Data was collected from the medical records of coronary artery bypass grafting patients aged 30-70 years at Buddachinaraj Phitsanulok Hospital from January 1 to December 31, 2024, according to inclusion and exclusion criteria. The total sample consisted of 60 patients: 30 patients received del Nido cardioplegia, and 30 patients received cardioplegia solution. The study results showed that among patients receiving del Nido cardioplegia solution and those receiving cardioplegia solution with a pacemaker, one (3.3%) and eight (26.7%), respectively (p = 0.026), had atrial fibrillation in six (20.0%) and seven (23.3%), respectively (p = 1.000), and ventricular fibrillation in four (13.3%) and seven (23.3%), respectively (p = 0.506). Conclusion, the patients who received del Nido cardioplegia required a pacemaker after surgery was fewer than patients who received conventional cardioplegia. The incidence of atrial fibrillation and ventricular fibrillation were similar between patients who received each type of cardioplegia solution

References

Suwanakitch P. Heart-lung machine: Principle and practice. Phitsanulok, Thailand; Naresuan University Publishing House; 2018. p. 1-12.

The Society of Thoracic Surgeon of Thailand. Heart surgery statistics in Thailand 2024 [Internet]. 2026 [cited 2026 July 19]. Available from: https://thaists.or.th

Wiriyatharakij T. Modified del Nido Cardioplegia. Thai J Hosp Pharm 2021;31(3):293-304.

Sanetra K, Pawlak I, Cisowski M. Del Nido cardioplegia-what is the current evident? Kardiochir Torakochirurgia Pol 2018;15(2):114-8.

Matte GS, del Nido PJ. History and use of del Nido cardioplegia solution at Boston Children’s Hospital. K Extra Corpor Technol 2012;44(3):98-103.

Michael RR, Ernesto J, Shuab O, Lorraine DC, Sabrina XR, Ourania P, et al. Single-dose del Nido cardioplegia compared with standard cardioplegia during coronary artery bypass grafting at a veterans affairs hospital. Tex Heart Inst J 2021:48(1):1-7.

Graffigna A, Nollo G, Pederzolli C, Ferrari P, Widesott L, Antolini R. Continuous monitoring of myocardial acid–base status during intermittent warm blood cardioplegia. Eur J Cardiothorac Surg 2002;21(6):995-1001.

Khuri SF, Healey NA, Hossain M, Birjiniuk V, Crittenden MD, Josa M, et al. Intraoperative regional myocardial acidosis and reduction in long-term survival after cardiac surgery. J Thorac Cardiovasc Surg 2005;129(2):372-81.

Mitrakul A, Chiramongkol S, Kochaiyapatana P, Kochaiyapatana K. Cardiac rehabilitation in CABG patients. Bu J Med 2023;10(2):89-100.

Lee S, Jung JC, Chang HW, Lee JH, Kim DJ, Kim JS, et al. Comparative analysis of del Nido cardioplegia versus blood cardioplegia in isolate coronary artery bypass grafting. J Cardiothorac Surg 2024;19:1-7. https://doi.org/10.1186/s13019-024-02853-1

Ad N, Holmes SD, Massimiano PS, Rongione AJ, Fornaresio LM, Fitzgerald D. The use of del Nido cardioplegia in adult cardiac surgery: A prospective randomized trial. J Thorac Cardiovasc Surg 2018;155(3):1011–8.

Nardi P, Pisano C, Bertoldo F, Ruvolo G. New insights on the use of del Nido cardioplegia in the adult cardiac surgery. J Thorac Dis 2018;10(Suppl 26):S3233-6.

Tsukube T, McCully JD, Federman M, Krukenkamp IB, Levitsky S. Developmental differences in cytosolic calcium accumulation associated with surgically induced global ischemia: optimization of cardioplegic protection and mechanism of action. J Thorac Cardiovasc Surg 1996;112(1):175-84.

O'Brien JD, Howlett SE, Burton HJ, O'Blenes SB, Litz DS, Friesen CLH. Pediatric cardioplegia strategy results in enhanced calcium metabolism and lower serum troponin T. Ann Thorac Surg 2009;87(5):1517-23.

Govindapillai A, Hua R, Rose R, Friesen CH, O'Blenes SB. Protecting the aged heart during cardiac surgery: Use of del Nido cardioplegia provides superior functional recovery in isolated hearts. J Thorac Cardiovasc Surg 2013;146(4):940-8.