The Importance of Hyperkalemia in a Cold Perfusion Solution

A Correlative Study Examining Myocardial Function, Metabolism, Tissue Gases, and Substrates

William H. Heydorn, Col, William Y. Moores, John Mack, Walter Dembitsky

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Twenty-four pigs were studied to assess the effect of potassium in a cardioplegic solution on the ability of the swine myocardium to maintain functional and metabolic integrity following induced ischemia. The pigs were evaluated on total and right heart bypass with measurement at normothermia and after a one-hour intervention of stroke volume (SV), coronary blood flow (CBF), myocardial oxygen consumption (MVo2), and lactate extraction. Myocardial tissue gases (PmO2 and PmCO2) were continuously monitored and, at the conclusion of the procedure tissues were analyzed for adenosine triphosphate (ATP). There were five interventions: (1) hypothermic perfusion (28°C) (Group 1); (2) hypothermic ischemia (28°C) (Group 2); and hypothermic ischemia with a cardioplegic solution (nonlactated Ringer's solution, pH 7.4, 4°C) using (3) normokalemia (4 mEq of potassium chloride/L, 300 mOsm/L) (Group 3), (4) hyperkalemia (43 mEq of KC1/L, 390 mOsm/L) (Group 4), and (5) normokalemia with increased osmolality (3.6 mEq of KC1/L, 400 mOsm/L) (Groups 5). A significant decrease in SV and elevation in peak PmCO2 were seen in all groups subjected to ischemia except those protected with hyperkalemic solution. We conclude that the presence of hyperkalemia in a cold root perfusion solution provides better myocardial protection than cold root perfusion alone. Furthermore, potassium arrest appears to be more protective than coronary perfusion at 28°C.

Original languageEnglish (US)
Pages (from-to)281-289
Number of pages9
JournalAnnals of Thoracic Surgery
Volume28
Issue number3
DOIs
StatePublished - Jan 1 1979

Fingerprint

Hyperkalemia
Ischemia
Perfusion
Gases
Cardioplegic Solutions
Swine
Stroke Volume
Potassium
Right Heart Bypass
Potassium Chloride
Oxygen Consumption
Osmolar Concentration
Lactic Acid
Myocardium
Adenosine Triphosphate

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

The Importance of Hyperkalemia in a Cold Perfusion Solution : A Correlative Study Examining Myocardial Function, Metabolism, Tissue Gases, and Substrates. / Heydorn, William H.; Col; Moores, William Y.; Mack, John; Dembitsky, Walter.

In: Annals of Thoracic Surgery, Vol. 28, No. 3, 01.01.1979, p. 281-289.

Research output: Contribution to journalArticle

@article{98579872932b421da09069d7b4194180,
title = "The Importance of Hyperkalemia in a Cold Perfusion Solution: A Correlative Study Examining Myocardial Function, Metabolism, Tissue Gases, and Substrates",
abstract = "Twenty-four pigs were studied to assess the effect of potassium in a cardioplegic solution on the ability of the swine myocardium to maintain functional and metabolic integrity following induced ischemia. The pigs were evaluated on total and right heart bypass with measurement at normothermia and after a one-hour intervention of stroke volume (SV), coronary blood flow (CBF), myocardial oxygen consumption (MVo2), and lactate extraction. Myocardial tissue gases (PmO2 and PmCO2) were continuously monitored and, at the conclusion of the procedure tissues were analyzed for adenosine triphosphate (ATP). There were five interventions: (1) hypothermic perfusion (28°C) (Group 1); (2) hypothermic ischemia (28°C) (Group 2); and hypothermic ischemia with a cardioplegic solution (nonlactated Ringer's solution, pH 7.4, 4°C) using (3) normokalemia (4 mEq of potassium chloride/L, 300 mOsm/L) (Group 3), (4) hyperkalemia (43 mEq of KC1/L, 390 mOsm/L) (Group 4), and (5) normokalemia with increased osmolality (3.6 mEq of KC1/L, 400 mOsm/L) (Groups 5). A significant decrease in SV and elevation in peak PmCO2 were seen in all groups subjected to ischemia except those protected with hyperkalemic solution. We conclude that the presence of hyperkalemia in a cold root perfusion solution provides better myocardial protection than cold root perfusion alone. Furthermore, potassium arrest appears to be more protective than coronary perfusion at 28°C.",
author = "Heydorn, {William H.} and Col and Moores, {William Y.} and John Mack and Walter Dembitsky",
year = "1979",
month = "1",
day = "1",
doi = "10.1016/S0003-4975(10)63121-9",
language = "English (US)",
volume = "28",
pages = "281--289",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "3",

}

TY - JOUR

T1 - The Importance of Hyperkalemia in a Cold Perfusion Solution

T2 - A Correlative Study Examining Myocardial Function, Metabolism, Tissue Gases, and Substrates

AU - Heydorn, William H.

AU - Col,

AU - Moores, William Y.

AU - Mack, John

AU - Dembitsky, Walter

PY - 1979/1/1

Y1 - 1979/1/1

N2 - Twenty-four pigs were studied to assess the effect of potassium in a cardioplegic solution on the ability of the swine myocardium to maintain functional and metabolic integrity following induced ischemia. The pigs were evaluated on total and right heart bypass with measurement at normothermia and after a one-hour intervention of stroke volume (SV), coronary blood flow (CBF), myocardial oxygen consumption (MVo2), and lactate extraction. Myocardial tissue gases (PmO2 and PmCO2) were continuously monitored and, at the conclusion of the procedure tissues were analyzed for adenosine triphosphate (ATP). There were five interventions: (1) hypothermic perfusion (28°C) (Group 1); (2) hypothermic ischemia (28°C) (Group 2); and hypothermic ischemia with a cardioplegic solution (nonlactated Ringer's solution, pH 7.4, 4°C) using (3) normokalemia (4 mEq of potassium chloride/L, 300 mOsm/L) (Group 3), (4) hyperkalemia (43 mEq of KC1/L, 390 mOsm/L) (Group 4), and (5) normokalemia with increased osmolality (3.6 mEq of KC1/L, 400 mOsm/L) (Groups 5). A significant decrease in SV and elevation in peak PmCO2 were seen in all groups subjected to ischemia except those protected with hyperkalemic solution. We conclude that the presence of hyperkalemia in a cold root perfusion solution provides better myocardial protection than cold root perfusion alone. Furthermore, potassium arrest appears to be more protective than coronary perfusion at 28°C.

AB - Twenty-four pigs were studied to assess the effect of potassium in a cardioplegic solution on the ability of the swine myocardium to maintain functional and metabolic integrity following induced ischemia. The pigs were evaluated on total and right heart bypass with measurement at normothermia and after a one-hour intervention of stroke volume (SV), coronary blood flow (CBF), myocardial oxygen consumption (MVo2), and lactate extraction. Myocardial tissue gases (PmO2 and PmCO2) were continuously monitored and, at the conclusion of the procedure tissues were analyzed for adenosine triphosphate (ATP). There were five interventions: (1) hypothermic perfusion (28°C) (Group 1); (2) hypothermic ischemia (28°C) (Group 2); and hypothermic ischemia with a cardioplegic solution (nonlactated Ringer's solution, pH 7.4, 4°C) using (3) normokalemia (4 mEq of potassium chloride/L, 300 mOsm/L) (Group 3), (4) hyperkalemia (43 mEq of KC1/L, 390 mOsm/L) (Group 4), and (5) normokalemia with increased osmolality (3.6 mEq of KC1/L, 400 mOsm/L) (Groups 5). A significant decrease in SV and elevation in peak PmCO2 were seen in all groups subjected to ischemia except those protected with hyperkalemic solution. We conclude that the presence of hyperkalemia in a cold root perfusion solution provides better myocardial protection than cold root perfusion alone. Furthermore, potassium arrest appears to be more protective than coronary perfusion at 28°C.

UR - http://www.scopus.com/inward/record.url?scp=0018649766&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0018649766&partnerID=8YFLogxK

U2 - 10.1016/S0003-4975(10)63121-9

DO - 10.1016/S0003-4975(10)63121-9

M3 - Article

VL - 28

SP - 281

EP - 289

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 3

ER -