What does this research mean for the field?

Adenosine-lidocaine-magnesium polarizing cardioplegia results in significantly lower postoperative high-sensitivity troponin I leakage and reduced vasoactive inotropic requirements compared to Buckberg depolarizing cardioplegia in adult cardiac surgery. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

October 17, 2021European Journal of Cardio-Thoracic SurgeryOpen Access

Short-term outcome of adenosine–lidocaine–magnesium polarizing cardioplegia in humans

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: elective routine adult cardiac surgery (n=1000). Intervention: normokalaemic adenosine-lidocaine-magnesium (ALM) blood polarizing cardioplegia vs. hyperkalaemic blood Buckberg depolarizing cardioplegia. Primary outcome: perioperative leakage of high-sensitivity troponin I (Hs-TnI) (p=<0.001).

View Full Paper

Ask AI

Bookmark

Key result

Adenosine-lidocaine-magnesium cardioplegia is linked to lower postoperative Hs-TnI leakage versus Buckberg.

P<0.001
n=1,000

Why the study?

Hyperkalaemic depolarized arrest has potassium-related cytotoxicity, while preclinical studies suggest polarized arrest offers better myocardial protection.

Does normokalaemic adenosine-lidocaine-magnesium (ALM) blood polarizing cardioplegia improve myocardial protection and hospital outcomes compared to hyperkalaemic blood Buckberg depolarizing cardioplegia in elective adult cardiac surgery?

Comparison

Normokalaemic ALM polarizing cardioplegia vs hyperkalaemic Buckberg depolarizing cardioplegia

Design

Observational propensity score-matched cohort study

Authors

AFAlessandra FrancicaUniversity of Verona AVArianna Vaccarin GDGeoffrey P. DobsonJames Cook University

Discussion

Member takes

Implication

Should not yet change cardioplegia choice; leaves open whether randomized trials confirm myocardial protection with ALM.

Study Design

Type

Cohort (n=1,000)

Structured PICO

Population

1,000 consecutive adult patients undergoing elective routine cardiac surgery.

Exposure

Normokalaemic adenosine-lidocaine-magnesium (ALM) blood polarizing cardioplegia

Comparator

Hyperkalaemic blood Buckberg depolarizing cardioplegia

Outcome

Quality of myocardial protection and hospital outcome (perioperative leakage of high-sensitivity troponin I [Hs-TnI], peripheral lactate, maximal vasoactive inotropic score [VISMAX], hospital mortality and morbidity)surrogate

Main Result

p-value: p=<0.001

ALM polarizing cardioplegia provides superior myocardial protection, evidenced by lower troponin release and reduced inotropic requirements, compared to Buckberg depolarizing cardioplegia in elective adult cardiac surgery, despite comparable short-term clinical outcomes.

Cite This Study

Francica et al. (2021) conducted a cohort in elective routine adult cardiac surgery (n=1,000). normokalaemic adenosine-lidocaine-magnesium (ALM) blood polarizing cardioplegia vs. hyperkalaemic blood Buckberg depolarizing cardioplegia was evaluated on perioperative leakage of high-sensitivity troponin I (Hs-TnI) (p=<0.001). Adenosine-lidocaine-magnesium polarizing cardioplegia resulted in significantly lower postoperative high-sensitivity troponin I leakage (P<0.001) compared to Buckberg depolarizing cardioplegia.

synapsesocial.com/papers/6aa86fd8a2ea35927a1e983e https://doi.org/10.1093/ejcts/ezab466

View Full Paper

Ask AI

Bookmark

Short-term outcome of adenosine–lidocaine–magnesium polarizing cardioplegia in humans

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Short-term outcome of adenosine–lidocaine–magnesium polarizing cardioplegia in humans

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider