Indian J Anaesth. 2026 Jul;70(7):821-828. doi: 10.4103/ija.ija_1635_25. Epub 2026 Jul 21.
ABSTRACT
BACKGROUND AND AIMS: del Nido cardioplegia (DC), initially developed for paediatric cardiac surgery, is increasingly used in adult procedures due to its ability to provide prolonged myocardial protection with a single dose. However, its superiority over blood cardioplegia (BC) remains unclear. This study compared the effects of DC and BC on acid-base balance, potassium levels, and metabolic profiles in adults undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).
METHODS: A retrospective observational study was conducted at a tertiary care centre over a period of 6 months. Forty-seven patients were divided into Group BC (received blood cardioplegia) and Group DC (received del Nido cardioplegia). Arterial blood gases were recorded at four intraoperative time points. The four time points were T1, baseline before CPB; T2, immediately after cardioplegia administration; T3, post-rewarming just before separation from CPB; and T4, before transfer to the intensive care unit. Statistical analyses were performed using independent t-tests and Chi-square tests, or their equivalent non-parametric alternatives when appropriate.
RESULTS: Group DC exhibited a significantly higher potential of hydrogen (pH) (7.49 vs 7.43, P = 0.003) and base excess (0.15 vs – 1.80 mmol/L, P = 0.014) at post-rewarming (T3). Potassium was lower in group DC at baseline (T1). Blood glucose was significantly higher in group BC at T3 (275 vs 207 mg/dL, P < 0.001) and T4 (258 vs 217 mg/dL, P = 0.033). Five patients in the DC group required blood transfusion during CPB.
CONCLUSION: DC and BC showed largely comparable intraoperative metabolic and physiological profiles, with most observed differences remaining within acceptable physiological ranges and of limited clinical significance. DC may be a practical alternative to BC; however, larger prospective studies evaluating direct myocardial injury markers and postoperative outcomes are needed.
PMID:42500639 | PMC:PMC13399266 | DOI:10.4103/ija.ija_1635_25
