Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery

Abstract Background Del Nido cardioplegia (DNC) has been proven safe and effective in pediatric patients. However, the use of DNC in adult undergoing cardiovascular surgery lacks support with substantial evidence. This study aimed to evaluate the efficacy of DNC as a cardioplegia of prophylaxis to v...

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Main Authors: Chang Shu, Liang Hong, Xiao Shen, Wenhao Zhang, Yongsheng Niu, Xiaochun Song, Jie Kong, Cui Zhang
Format: Article
Language:English
Published: BMC 2021-01-01
Series:BMC Cardiovascular Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12872-020-01844-z
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author Chang Shu
Liang Hong
Xiao Shen
Wenhao Zhang
Yongsheng Niu
Xiaochun Song
Jie Kong
Cui Zhang
author_facet Chang Shu
Liang Hong
Xiao Shen
Wenhao Zhang
Yongsheng Niu
Xiaochun Song
Jie Kong
Cui Zhang
author_sort Chang Shu
collection DOAJ
description Abstract Background Del Nido cardioplegia (DNC) has been proven safe and effective in pediatric patients. However, the use of DNC in adult undergoing cardiovascular surgery lacks support with substantial evidence. This study aimed to evaluate the efficacy of DNC as a cardioplegia of prophylaxis to ventricular arrhythmias associated to cardiovascular surgery in adult patients. Methods This study recruited nine hundred fifty-four patients who underwent cardiopulmonary bypass surgeries in Nanjing Hospital affiliated to Nanjing Medical University between January 2019 and December 2019. Among 954 patients, 324 patients were treated with DNC (DNC group), and 630 patients were treated with St. Thomas cardioplegia (STH group). The incidence of postoperative arrhythmia as well as other cardiovascular events relavant to the surgery were investigated in both groups. Results In DNC group, the incidence of postoperative ventricular arrhythmias was lower (12.4% vs. 17.4%, P = 0.040), and the length of ICU stay was shorter (1.97 ± 1.49 vs. 2.26 ± 1.46, P = 0.004). Multivariate logistic regression demonstrated that the use of DNC helped to reduce the incidence of postoperative ventricular arrhythmias (adjusted odds ratio 0.475, 95% CI 0.266–0.825, P = 0.010). The propensity score-based analysis and subgroup analysis indicated that DNC has the same protecting effects towards myocardial in all kinds of cardiopulmonary bypass surgeries. Conclusions Del Nido cardioplegia may potentially reduce the incidence of postoperative ventricular arrhythmias, shorten the length of ICU stay and improve the overall outcome of the patients undergoing cardiovascular surgery.
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spelling doaj.art-f3272e2b8c244c0990ccf9ea6516d9bc2022-12-21T23:15:09ZengBMCBMC Cardiovascular Disorders1471-22612021-01-0121111110.1186/s12872-020-01844-zEffect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgeryChang Shu0Liang Hong1Xiao Shen2Wenhao Zhang3Yongsheng Niu4Xiaochun Song5Jie Kong6Cui Zhang7Department of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Interventional Radiology, Nanjing First Hospital, Nanjing Medical UniversityDepartment of Intensive Care Unit, Nanjing First Hospital, Nanjing Medical UniversityAbstract Background Del Nido cardioplegia (DNC) has been proven safe and effective in pediatric patients. However, the use of DNC in adult undergoing cardiovascular surgery lacks support with substantial evidence. This study aimed to evaluate the efficacy of DNC as a cardioplegia of prophylaxis to ventricular arrhythmias associated to cardiovascular surgery in adult patients. Methods This study recruited nine hundred fifty-four patients who underwent cardiopulmonary bypass surgeries in Nanjing Hospital affiliated to Nanjing Medical University between January 2019 and December 2019. Among 954 patients, 324 patients were treated with DNC (DNC group), and 630 patients were treated with St. Thomas cardioplegia (STH group). The incidence of postoperative arrhythmia as well as other cardiovascular events relavant to the surgery were investigated in both groups. Results In DNC group, the incidence of postoperative ventricular arrhythmias was lower (12.4% vs. 17.4%, P = 0.040), and the length of ICU stay was shorter (1.97 ± 1.49 vs. 2.26 ± 1.46, P = 0.004). Multivariate logistic regression demonstrated that the use of DNC helped to reduce the incidence of postoperative ventricular arrhythmias (adjusted odds ratio 0.475, 95% CI 0.266–0.825, P = 0.010). The propensity score-based analysis and subgroup analysis indicated that DNC has the same protecting effects towards myocardial in all kinds of cardiopulmonary bypass surgeries. Conclusions Del Nido cardioplegia may potentially reduce the incidence of postoperative ventricular arrhythmias, shorten the length of ICU stay and improve the overall outcome of the patients undergoing cardiovascular surgery.https://doi.org/10.1186/s12872-020-01844-zDel nidoCardioplegiaCardiopulmonary bypassArrhythmiaMyocardial damage
spellingShingle Chang Shu
Liang Hong
Xiao Shen
Wenhao Zhang
Yongsheng Niu
Xiaochun Song
Jie Kong
Cui Zhang
Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
BMC Cardiovascular Disorders
Del nido
Cardioplegia
Cardiopulmonary bypass
Arrhythmia
Myocardial damage
title Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
title_full Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
title_fullStr Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
title_full_unstemmed Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
title_short Effect of Del Nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
title_sort effect of del nido cardioplegia on ventricular arrhythmias after cardiovascular surgery
topic Del nido
Cardioplegia
Cardiopulmonary bypass
Arrhythmia
Myocardial damage
url https://doi.org/10.1186/s12872-020-01844-z
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