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The Journal of Thoracic and Cardiovascular Surgery, Vol 76, 698-705, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Protection of the ischemic myocardium. Volume-duration relationships and the efficacy of myocardial infusates

P Jynge, DJ Hearse and MV Braimbridge

In studies in the isolated rat heart that were designed to optimize the composition of the infusion conditions for a cardioplegic protective solutuin, we have observed a complex relationship between the duration and volume of infusion and the extent of tissue protection. Our results would indicate that solutions, such as that formulated at St. Thomas' Hospital, which are based on extracellular electrolyte content, afford (after a brief equilibration period) a constant degree of protection, irrespective of infusion volume or duration. In contrast other solutions, such as the Bretschneider solution, which have extremes of electrolyre concentration, are associated with a complex dose-response relationship. In the latter instance, infusion of small volumes for short durations affords an increasing degree of protection against ischemia. Increasing the infusate volume may result in a progressive loss of protection. Excessive infusion may lead to an exacerbation of ischemia-induced damage. Our studies suggest that the relative patterns and rates of re-equilibration of various ions, especially sodium and calcium, during infusion may play a major role in determining the efficacy of the infusate.


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Home page
 PerfusionHome page
U. von Oppell and E. Baudet
Myocardial protective effects of four different infusates in the human heart
Perfusion, July 1, 1990; 5(3): 223 - 225.
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