Vol. 84, December 2016

A Comparative Study for the Incidence of Hyponatremia Blood with Cardioplegia versus Histidine-Tryptophan-Ketoglutarate (HTK) Cardioplegia in Pediatric Patients Undergoing Total Corrective Cardiac Surgery

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A Comparative Study for the Incidence of Hyponatremia Blood with Cardioplegia versus Histidine-Tryptophan-Ketoglutarate (HTK) Cardioplegia in Pediatric Patients Undergoing Total Corrective Cardiac Surgery, AMEL ABO EL-ELA, REHAM MAHROUS, AHMED MUKHTAR, DALIA SAAD, ASHRAF ABD AL-REHEEM, AHMED KAREEM and HOSSAM HASANIEN

 

Abstract
Background: Despite potential benefits of Histidine-Tryp-tophan-Ketoglutarate (HTK) solution as a cardioplegic solution, it is known to cause hyponatremia, especially in pediatric patients. Fluctuations in the sodium concentration during Cardiopulmonary Bypass (CPB) affects the central nervous system hyponatremia is the most common electrolyte disorder in hospitalized patients and is known to be associated with increased mortality.
Methods: This prospective study was conducted on 64 pediatric patients with congenital heart disease in the Cardi-othoracic Department in Abo Al-Reesh Hospital scheduled for open total corrective surgery who were randomly assigned to receive either repeated doses of cold blood cardioplegia 20ml/kg of the blood cardiolpegic solution was administrated initially followed by 10ml/kg (Group B: 32 patients) or a single dose of 50ml/kg HTK cardioplegic solution (Group H: 32 patients). Serum sodium was measured immediately after induction of anesthesia (baseline value) and on postoperative day one in ICU.
Results: Serum sodium was comparable between both groups at baseline, however, it increased significantly relative to baseline in control group postoperatively. Postoperative serum sodium level was significantly higher in the control group compared to HTK group.
Conclusion: The HTK cardioplegic solution was not found to cause significant hyponatremia in our study.

 

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