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Histidine-tryptophan-ketoglutarate solution versus blood cardioplegia in cardiac surgery: A propensity-score matched analysis

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dc.creatorPizano, Alejandrospa
dc.creatorMontes, Felix Ramonspa
dc.creatorCarreño, Marisolspa
dc.creatorEcheverri, Dariospa
dc.creatorUmaña, Juan Pablospa
dc.date.accessioned2020-05-26T00:09:56Z
dc.date.available2020-05-26T00:09:56Z
dc.date.created2018spa
dc.description.abstractBackground: Choosing a cardioplegic solution is a significant issue in modern cardiac surgery. Although different options are available, the optimal strategy for myocardial protection has not been established. The aim of this study was to compare intraoperative and postoperative effects of histidine–tryptophan–ketoglutarate (HTK) solution with those of standard blood cardioplegia with St Thomas No 2 solution. The study was conducted using a large cohort of adult patients undergoing complex cardiac surgery. Methods: This study was a single center retrospective review of prospectively collected data. Between January 2008 and December 2015, 4480 patients underwent cardiac surgery using cardiopulmonary bypass (CPB) and cardioplegic arrest. Patients were divided into a blood cardioplegia group (n = 3852) and an HTK solution group (n = 628). Propensity score matching was used to adjust for differences between the two groups, and 292 matched pairs were identified. The primary end point was Intensive Care Unit (ICU) length of stay (LOS). Secondary end points included intraoperative changes in serum sodium concentration, readmission to ICU, transfusion of blood products, 30-day hospital readmission, 30-day mortality, and the incidence of major postoperative complications. Results: No significant differences were found between the matched groups with regard to baseline characteristics. Aortic cross-clamp and CPB times were longer for the blood cardioplegia (147.4 versus 132.8 min; P less than .001). Administration of HTK solution was associated with acute and transient hyponatremia (141 versus 130 mmol/L; P less than .001). ICU LOS was comparable between the groups (5.4 versus 5.4 days; P = .585). No significant differences were noted in any other secondary end point. Conclusions: During complex cardiac surgery, both cardioplegia techniques were equivalent in terms of early clinical outcomes. © 2018 Forum Multimedia Publishing, LLC.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.1532/hsf.1920
dc.identifier.issn15226662
dc.identifier.issn10983511
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/24190
dc.language.isoengspa
dc.publisherForum Multimedia Publishing LLCspa
dc.relation.citationEndPageE164
dc.relation.citationIssueNo. 3
dc.relation.citationStartPageE158
dc.relation.citationTitleHeart Surgery Forum
dc.relation.citationVolumeVol. 21
dc.relation.ispartofHeart Surgery Forum, ISSN:15226662, 10983511, Vol.21, No.3 (2018); pp. E158-E164spa
dc.relation.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85051034262&doi=10.1532%2fhsf.1920&partnerID=40&md5=d862291a4ea1077dab21856a02be4a51spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordHTK solutionspa
dc.subject.keywordPlegisolspa
dc.subject.keywordSodiumspa
dc.subject.keywordCardioplegic agentspa
dc.subject.keywordGlucosespa
dc.subject.keywordHTK solutionspa
dc.subject.keywordMannitolspa
dc.subject.keywordPotassium chloridespa
dc.subject.keywordProcainespa
dc.subject.keywordAdultspa
dc.subject.keywordArticlespa
dc.subject.keywordBlood transfusionspa
dc.subject.keywordCardiopulmonary bypassspa
dc.subject.keywordClinical outcomespa
dc.subject.keywordCohort analysisspa
dc.subject.keywordComparative studyspa
dc.subject.keywordControlled studyspa
dc.subject.keywordDrug effectspa
dc.subject.keywordFemalespa
dc.subject.keywordHeart surgeryspa
dc.subject.keywordHospital readmissionspa
dc.subject.keywordHumanspa
dc.subject.keywordHyponatremiaspa
dc.subject.keywordIncidencespa
dc.subject.keywordIntensive care unitspa
dc.subject.keywordLength of stayspa
dc.subject.keywordMajor clinical studyspa
dc.subject.keywordMalespa
dc.subject.keywordMiddle agedspa
dc.subject.keywordMortality ratespa
dc.subject.keywordPeroperative carespa
dc.subject.keywordPostoperative carespa
dc.subject.keywordPostoperative complicationspa
dc.subject.keywordPriority journalspa
dc.subject.keywordPropensity scorespa
dc.subject.keywordProspective studyspa
dc.subject.keywordRetrospective studyspa
dc.subject.keywordSodium blood levelspa
dc.subject.keywordColombiaspa
dc.subject.keywordFollow upspa
dc.subject.keywordHeart arrestspa
dc.subject.keywordHeart diseasespa
dc.subject.keywordMortalityspa
dc.subject.keywordPostoperative complicationspa
dc.subject.keywordProceduresspa
dc.subject.keywordPropensity scorespa
dc.subject.keywordSurvival ratespa
dc.subject.keywordTrendsspa
dc.subject.keywordCardiac Surgical Proceduresspa
dc.subject.keywordCardioplegic Solutionsspa
dc.subject.keywordColombiaspa
dc.subject.keywordFemalespa
dc.subject.keywordFollow-Up Studiesspa
dc.subject.keywordGlucosespa
dc.subject.keywordHeart Arresteng
dc.subject.keywordHeart Diseasesspa
dc.subject.keywordHumansspa
dc.subject.keywordIncidencespa
dc.subject.keywordMalespa
dc.subject.keywordMannitolspa
dc.subject.keywordMiddle Agedspa
dc.subject.keywordPostoperative Complicationsspa
dc.subject.keywordPotassium Chloridespa
dc.subject.keywordProcainespa
dc.subject.keywordPropensity Scorespa
dc.subject.keywordRetrospective Studiesspa
dc.subject.keywordSurvival Ratespa
dc.titleHistidine-tryptophan-ketoglutarate solution versus blood cardioplegia in cardiac surgery: A propensity-score matched analysisspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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