Global Teamwork in Modern Myocardial Protection: Alternative Base Solutions for del Nido Cardioplegia

Alternative Base Solutions for del Nido Cardioplegia: Composition, Rationale, and Clinical Evidence

January 31, 2026 No Comments

This comprehensive review examines alternative crystalloid and whole-blood base solutions for del Nido cardioplegia, including normal saline, lactated Ringer’s, plain Ringer’s, Isolyte S, Ionosteril, and whole blood. Drawing on experimental models, randomized trials, and clinical studies, the article demonstrates that these alternatives provide myocardial protection and postoperative outcomes comparable to Plasma-Lyte A when appropriately buffered, supporting cost-effective and globally accessible cardiac surgery practice.

Active Myocardial Protection During Cardioplegic Arrest

Molecular and Cellular Mechanisms of Cardioplegic Protection in Surgical Myocardial Revascularization

January 31, 2026 No Comments

This comprehensive review explores how cardioplegia actively protects the myocardium during coronary artery bypass grafting. Beyond inducing cardiac arrest, cardioplegic solutions modulate calcium homeostasis, mitochondrial function, oxidative stress, inflammation, and apoptosis. By suppressing electromechanical activity and metabolic demand, cardioplegia prolongs ischemic tolerance and mitigates reperfusion injury, offering critical insights for optimizing myocardial protection strategies in modern cardiac surgery.

Comparison of 6% Hydroxyethyl Starch 130/0.4 vs 5% Albumin in Cardiopulmonary Bypass for Cardiac Surgery

January 31, 2026 No Comments

This meta-analysis evaluated 12 randomized trials (908 patients) comparing 6% hydroxyethyl starch (HES) 130/0.4 with 5% albumin during cardiopulmonary bypass in cardiac surgery. Most outcomes—including blood loss, transfusion rates, ICU stay, hospital stay, and mortality—were similar between groups. However, HES use was associated with a significantly higher risk of acute kidney injury, highlighting renal safety concerns despite comparable hemodynamic efficacy.