Cardioplegia

Cardiopulmonary bypass and open heart surgery to induce ischaemic cardiac arrest. It is usually combined with hypothermia to further assist the cardiac arrest.

Indications

Anesthesia for Congenital Heart Surgery. James A. Myocardial preservation techniques for mini-bypass. Bleeding after Cardiac Surgery. Intracardiac Devices, Catheters, and Cannulas. Principles of Liver Preservation. Kidney Preservation. Cardiopulmonary Bypass and Management. Diagnosis and Therapy of Graft Dysfunction.

Dosage

It must be diluted before use. 20ml of the drug is added to 1 litre of Ringer's solution. The solution is cooled to 2-8OC prior to use and the solution is administered by rapid instillation into the aortic root, after institution of cardiopulmonary bypass and cross clamping of the ascending aorta, at the rate of 300ml/m2 body surface area/min., for 3 times, initially. External cardiac cooling helps to ensure maintenance of a continuously cold heart. Warmed instillate can be removed by cold solu

Contra-Indications

Cardioplegic Solution must not be administered without the addition of 8.4% Sodium Bicarbonate Injection, USP, Hospira1 List 4900.

Special Precautions

Myocardial temperature should be monitored during surgery to maintain hypothermia. Continuous electrocardiogram monitoring is essential to detect changes in myocardial activity during the procedure. Appropriate equipment to defibrillate the heart following cardioplegia should be readily available. Inotropic support drugs should be available during postoperative recovery. Do not administer unless solution is clear and container is undamaged.

Side Effects

The most commonly reported side-effects of Cardioplegia are myocardial infarction, electrocardiographic abnormalities, and arrhythmias.

Drug Interactions

Additives may be incompatible. Consult with pharmacist, if available. When introducing additives, use aseptic technique, mix thoroughly and do not store.