Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate - a retrospective study

作者：Lindner Gregor^*; Zapletal Bernhard; Schwarz Christoph; Wisser Wilfried; Hiesmayr Michael; Lassnigg Andrea

来源：Journal of Cardiothoracic Surgery, 2012, 7(1): 52.

DOI：10.1186/1749-8090-7-52

• Hyponatremia
• Minimally invasive aortic valve replacement
• Bretschneider cardioplegia

Background: Hyponatremia is the most common electrolyte disorder in hospitalized patients and is known to be associated with increased mortality. The administration of antegrade single-shot, up to two liters, histidine-tryptophane-ketoglutarate (HTK) solution for adequate electromechanical cardiac arrest and myocardial preservation during minimally invasive aortic valve replacement (MIAVR) is a standard procedure. We aimed to determine the impact of HTK infusion on electrolyte and acid-base balance. %26lt;br%26gt;Methods: In this retrospective analysis we reviewed data on patient characteristics, type of surgery, arterial blood gas analysis during surgery and intra-/postoperative laboratory results of patients receiving surgery for MIAVR at a large tertiary care university hospital. %26lt;br%26gt;Results: A total of 25 patients were included in the study. All patients were normonatremic at start of surgery. All patients developed hyponatremia after administration of HTK solution with a significant drop of serum sodium of 15 mmol/L (p%26lt;0.01). Measured osmolality did not change during all times of surgery compared to start of surgery (p = 0.28 - p = 0.79), indicating isotonic hyponatremia. After administration of HTK solution pH fell significantly due to development of metabolic acidosis. %26lt;br%26gt;Conclusions: Acute hyponatremia during cardioplegia with HTK solution is isotonic and should probably not be corrected without presence of hypotonicity as confirmed by measurement of serum osmolality.

• 出版日期2012-6-10