custodiol cardioplegia solution

Aims We aimed to evaluate the benefit of custodiol cardioplegia in comparison with the conventional one in supporting training programs. Custodiol HTK Histidine Tryptophan Ketoglutarate Solution is used by leading Cardiac Surgery Centers as a cardioplegic solution worldwide.

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The standard ratio cardioplegia set will be used with the inflow line to from oxygenator clamped.

. This is due to its comparatively low viscosity which equals the one of water 20 cP. While UW provides lactobionate and raffinose Custodiol uses mannitol a very safe product. This is an advantage over other cardioplegic solutions that may have to be re administered every 20-30.

Custodiol HTK hyperpolarizes the heart to induce cardiac arrest. Custodiol also known as histidine-tryptophan-α-ketoglutarate HTK Bretschneider solution is an attractive cardioplegic solution for longer cardiac operations because it is applied in a single dose and protects the myocardium for up to 4 h. Compared to Custodiol Custodiol-N is supplemented with the iron chelators deferoxamine and LK-614 which reduce iron-dependent injury.

Sodium-channel blockers cause the cell membrane to become slightly polarized in comparison to depolarizing solutions without these agents. Custodiol solution is administered in a single-dose allowing the operation to be done continuously. Cardioplegia Custodiol HTK Kӧhler Chemie GmbH Germany is intracellular ionic composed cardioplegia low K with the addition of three amino acids histidine tryptophan ketoglutarate and based on Bretschneiders solution introduced in 1975 5.

Custodiol is an intracellular crystalloid cardioplegia solution that is a single-dose alternative to multi-dose cold blood cardioplegia. Custodiol HTK must be stored refrigerated at 2-10C. Inducing cardiac arrest usually implies slow infusion of the HTK solution at a temperature of 58 C into the.

With low concentrations of Na and Ca 2 ions Custodiol cardioplegia inhibits action potential formation producing diastolic cardiac arrest. Since HTK solution can be used at cold as well as tepid temperatures the membrane potential changes. Custodiol cardioplegia is an attractive solution for many cardiac surgeons as a single dose provides a long period of myocardial protection.

CUSTODIOL can be used right away and no further additives are needed. The development of cardioplegic solutions was one of the major advances in cardiac surgery that allowed surgeons to extend period of ischemic arrest Custodiol-N the novel cardioplegic solution reduces ischemiareperfusion injury after cardiopulmonary bypass springermedizinde. Despite widespread use in Europe there is little data confirming its efficacy compared with conventional blood or crystalloid cardioplegia.

The objective of this study is to demonstrate that custodiol is not inferior to cold cardioplegic solution for myocardial protection by comparing standard cold blood cardioplegia to custodiol solution with respect to myocardial injury as measured by creatine phosphokinase mb isoenzyme ck-mbtroponin-i at 7 hours post surgery and changes in. The bridge should be open and the cardioplegia circuit primed. Custodiol histidine-tryptophanketoglutarate htk or bretschneiders solution is an intracellular crystalloid cardioplegia solution that is currently in use for myocardial preservation during.

The title of my lecture is Custodiol Cardioplegia. The blood cardioplegia group includes solutions such as Calafiore or Buckberg both with microplegia alternatives. Custodiol HTK based on its buffering capacity is often used as a single-dose product.

We have a membrane potential of around 50 mV at 8C. For calculation of the membrane potential we used the following data. Given its buffering capacity it showed promise as a single-dose antegrade crystalloid alternative to the popular commercially produced multidose product Plegisol PL.

The biochemical makeup of Custodiol HTK solution is. A Single-Dose Hyperpolarizing Solution The impact of a low-sodium solution on electrophysiology physiology solutions composition and. The primary aim of two studies was to determine efficacy of a particular surgical technique that happened to use Custodiol as cardioplegia 1923.

CUSTODIOL HTK CARDIOPLEGIC SOLUTION Solution indicated for cardioplegia in connection with cardiosurgical operations organ protection during operations under ischemia heart kidney liver preservation of organ transplants heart kidney liver lung pancreas together with venous or arterial segments. Another important aspect in this context is. Primary endpointmortality Nine studies reported mortality 51118-202325-27.

A hemoconcentrator should be placed in the CPB circuit at the time of setup whenever Custodial HTK is being used. To determine the outcomes related to Custodiol cardioplegia and compared similar surgical procedures. Hospira Inc USA and numerous blood cardioplegia admixtures.

We sought to compare the outcomes of cold blood cardioplegia versus. The solution is left in the organ vasculature during hypothermic storage and. There were no statistically significant differences noted for any of the endpoints studied after.

Table 1 Composition of the histidine-tryptophan-ketoglutarate solution Open in a separate window. Custodiol a crystalloid solution has been used in children as an alternative cardioplegia solution with the potential advantage of single dose administration with equivalent myocardial protection. Custodiol is a low viscosity solution with low levels of potassium low enough that Custodiol need not be flushed out of the organ prior to implantation and sodium.

From a clinical point of view CUSTODIOL can be quicker perfused without any need for pressurized perfusion. Despite widespread use in Europe the available data confirming its efficacy is little compared with conventional methods of cardioplegia. Custodiol also offers excellent buffering with Histidine whereas UW uses phosphate.

After propensity-score matching we were able to match 71 Custodiol cases one-to-one to those receiving blood cardioplegia. The objective of this study was to compare its impact on myocardial function in infants. CUSTODIOL preservation solution was used.

A total of 1900 cardiac surgical procedures were identified of which 126 7 utilized Custodiol and 1774 93 used blood cardioplegia as the primary cardioplegic agent. Hyperkalemic solutions containing sodium-channel blockers such as del Nido cardioplegia are classified as modified depolarizing solutions. However there is scarce data regarding its use in infants and children.

I always call it HTK solution since Custodiol is the item being given by the manufacturer. And if you administer the solution at 35C the membrane potential increases. CUSTODIOL HTK Solution is indicated for perfusion and flushing of donor kidneys liver pancreas and heart prior to removal from the donor or immediately after removal from the donor.

The low sodium allows for increased osmotic space for better buffering. Custodiol cardioplegia is attractive for minimally invasive cardiac surgery as a single dose provides a long period of myocardial protection. A product approved by US FDA as a Medical Device and being a Multi Organ solution is also the solution of organ cleaning during cardiac surgery.

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