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Del Nido cardioplegia versus other contemporary solutions for myocardial protection – a literature review

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Brzeska B., Karolak W., Żelechowski P., Łoś A., Ulatowski N., Pawlaczyk R.
European Journal of Translational and Clinical Medicine
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2023
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vol. 6
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issue 1
41-57
EN
Myocardial protection is one of the most important factors ensuring patient safety during cardiac surgery with the application of cardiopulmonary bypass. Infusion of cardioplegic solution into the coronary circulation protects the heart and provides a standstill operating field for the surgeon. Cold blood cardioplegia and crystalloid cardioplegia are the two main types of solutions with a long history of use and a large amount of research proving their eficacy and safety. Relatively new del Nido cardioplegia seems to be an interesting alternative. We reviewed the literature comparing del Nido cardioplegia with two other types of cardioplegic solutions. We took into consideration many diefrent clinical and biochemical aspects may indicate the quality of cardioprotection. Brzeska B, Karolak W, Żelechowski P, Łoś A, Ulatowski N, Pawlaczyk R. Del Nido cardioplegia versus other contemporary solutions for myocardial protection - a literature review. Eur J Transl Clin Med. 2023;6(1):41-57.
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Risk factors of acute respiratory distress syndrome after on-pump cardiac surgery in the INFLACOR cohort study

84%
Kowalik M. M., Lango R., Łoś A., Chmara M., Brzeziński M., Lewandowski K., Klapkowski A., Rogowski J.
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EN
Background: Acute respiratory distress syndrome (ARDS) is a serious complication after cardiac surgery with a variety of clinical risk factors. It was hypothesized that genome variants predispose these patients to it. Material and methods: A cohort of 509 adult Caucasians undergoing on-pump cardiac surgery were observed for postoperative ARDS defined by the Berlin definition. Clinical variables and 10 single-nucleotide variants of genes involved in inflammatory pathways were analyzed for associations with four groups, defined by paO2/fiO2 (PF) ratio: 1) no ARDS (PF > 300 mmHg), 2) mild ARDS (200 < PF ≤ 300 mm Hg), 3) moderate ARDS (100 < PF ≤ 200 mm Hg), and 4) severe ARDS (PF ≤ 100 mmHg). Variables remaining in trends at p < 0.05 were considered significant. Results: The prevalence of ARDS was 7.9%. Only LBP1 rs2232582 remained in a genotypic trend with ARDS aggravation (p = 0.08). Clinical variables associated with ARDS aggravation: impaired left ventricular ejection fraction (p = 0.04), pulmonary hypertension (p = 0.01), intraoperative hypotension (p = 0.009), and postoperative day 1 white blood cell count (p = 0.015). More aggravated ARDS was associated with longer mechanical ventilation (p=0.01) and length of stay in ICU (p = 0.002). Conclusions: The borderline association with LBP1 rs2232582 and the identified risk factors suggest possible involvement of the LPS-LBP1 pathway in ARDS of the INFLACOR cohort.
3
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Risk factors of acute respiratory distress syndrome after on-pump cardiac surgery in the INFLACOR cohort study

84%
Kowalik M. M., Lango R., Łoś A., Chmara M., Brzeziński M., Lewandowski K., Klapkowski A., Rogowski J.
European Journal of Translational and Clinical Medicine
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2020
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vol. 3
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issue 1
24-33
EN
Background Acute respiratory distress syndrome (ARDS) is a serious complication after cardiac surgery with a variety of clinical risk factors. It was hypothesized that genome variants predispose these patients to it. Material and methods A cohort of 509 adult Caucasians undergoing on-pump cardiac surgery were observed for postoperative ARDS defined by the Berlin definition. Clinical variables and 10 single-nucleotide variants of genes involved in inflammatory pathways were analyzed for associations with four groups, defined by paO2/fiO2 (PF) ratio: 1) no ARDS (PF > 300 mmHg), 2) mild ARDS (200 < PF ≤ 300 mm Hg), 3) moderate ARDS (100 < PF ≤ 200 mm Hg), and 4) severe ARDS (PF ≤ 100 mmHg). Variables remaining in trends at p < 0.05 were considered significant. Results The prevalence of ARDS was 7.9%. Only LBP1 rs2232582 remained in a genotypic trend with ARDS aggravation (p = 0.08). Clinical variables associated with ARDS aggravation: impaired left ventricular ejection fraction (p = 0.04), pulmonary hypertension (p = 0.01), intraoperative hypotension (p = 0.009), and postoperative day 1 white blood cell count (p = 0.015). More aggravated ARDS was associated with longer mechanical ventilation (p=0.01) and length of stay in ICU (p = 0.002). Conclusions The borderline association with LBP1 rs2232582 and the identified risk factors suggest possible involvement of the LPS-LBP1 pathway in ARDS of the INFLACOR cohort.
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