Abstract | BACKGROUND:
Hyponatremia is the most common electrolyte disorder in hospitalized patients and is known to be associated with increased mortality. The administration of antegrade single-shot, up to two liters, histidine-tryptophane-ketoglutarate ( HTK) solution for adequate electromechanical cardiac arrest and myocardial preservation during minimally invasive aortic valve replacement (MIAVR) is a standard procedure. We aimed to determine the impact of HTK infusion on electrolyte and acid-base balance. METHODS: In this retrospective analysis we reviewed data on patient characteristics, type of surgery, arterial blood gas analysis during surgery and intra-/postoperative laboratory results of patients receiving surgery for MIAVR at a large tertiary care university hospital. RESULTS: A total of 25 patients were included in the study. All patients were normonatremic at start of surgery. All patients developed hyponatremia after administration of HTK solution with a significant drop of serum sodium of 15 mmol/L (p < 0.01). Measured osmolality did not change during all times of surgery compared to start of surgery (p = 0.28 - p = 0.79), indicating isotonic hyponatremia. After administration of HTK solution pH fell significantly due to development of metabolic acidosis. CONCLUSIONS: Acute hyponatremia during cardioplegia with HTK solution is isotonic and should probably not be corrected without presence of hypotonicity as confirmed by measurement of serum osmolality.
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Authors | Gregor Lindner, Bernhard Zapletal, Christoph Schwarz, Wilfried Wisser, Michael Hiesmayr, Andrea Lassnigg |
Journal | Journal of cardiothoracic surgery
(J Cardiothorac Surg)
Vol. 7
Pg. 52
(Jun 10 2012)
ISSN: 1749-8090 [Electronic] England |
PMID | 22681759
(Publication Type: Journal Article)
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Chemical References |
- Bretschneider cardioplegic solution
- Cardioplegic Solutions
- Mannitol
- Procaine
- Potassium Chloride
- Glucose
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Topics |
- Aged
- Cardioplegic Solutions
(adverse effects, therapeutic use)
- Female
- Glucose
(adverse effects, therapeutic use)
- Heart Arrest, Induced
(methods)
- Heart Valve Prosthesis Implantation
- Humans
- Hyponatremia
(chemically induced)
- Male
- Mannitol
(adverse effects, therapeutic use)
- Middle Aged
- Osmolar Concentration
- Potassium Chloride
(adverse effects, therapeutic use)
- Procaine
(adverse effects, therapeutic use)
- Retrospective Studies
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