MYOCARDIAL PROTECTION DURING BYPASS AND ARREST - POSSIBLE HAZARD WITH LACTATE-CONTAINING INFUSATES

Abstract

Severe myocardial tissue damage may result from the use of prolonged ischemic arrest during cardiac surgery. A number of experimental and clinical studies were reported in which various protective agents were infused into the coronary vessels before the onset of ischemia in an attempt to reduce or delay this damage. Although these agents were undoubtedly able to protect the ischemic myocardium, their efficacy may be considerably reduced or enhanced by the composition of the medium in which these agents were dissolved. Experiments with a rat heart model of bypass and ischemic arrest showed that lactate-based media were detrimental to optimal tissue protection.