New Approaches To Cardioplegia: Alternatives To Hyperkalemia
NEW SOLUTIONS FOR THE HEART: AN UPDATE IN ADVANCED PERIOPERATIVE PROTECTION(2011)
Abstract
The current gold standard for cardioplegic arrest during cardiac surgery is to use a hyperkalemic (elevated potassium) solution
(either crystalloid or blood-based). Hyperkalemia induces arrest by shifting the resting membrane potential towards a positive
value (i.e. a depolarization) and is, therefore, classified as depolarized arrest. Despite its almost universal usage, depolarized
arrest has a number of disadvantages that make hyperkalemia, potentially, a less than optimal means of inducing arrest. Thus,
alternative arresting methods and agents, which may be beneficial, have been explored. This chapter describes the disadvantages
of depolarized arrest and highlights the alternative agents that could possibly be used in a clinical setting to induce alternative
means of arrest, discussing their potential advantages and disadvantages.
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