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The effects of evacuation of Custodiol® in minimally invasive cardiac surgery
Hyung-Gon Je, MD1, Pil Je Kang1, Sang Kwon Lee1, Hyung Tae Kim1, Si Chan Sung1, Sang-Pil Kim2.
1Pusan National University Yangsan Hospital, Yangsan, Korea, Republic of, 2Pusan National University Hospital, Busan, Korea, Republic of.

The effects of evacuation of Custodiol® in minimally invasive cardiac surgery
OBJECTIVE:
Although Custodiol® has been widely used in cardiac surgeries, there are some concerns on Custodiol®-induced hyponatremia and following neurologic complications. Herein, we investigate the effects of Custodiol® evacuation during minimally invasive cardiac surgery (MICS).
METHODS:
From December 2008 to August 2012, 223 patients underwent MICS. After exclusion (blood cardioplegia, fibrillation, multiple cardioplegia), 142 patients were enrolled in this study. The control group (group 1, n=103) was compared to Custodiol® evacuated patients (group 2, n=39). Changes of sodium(ΔNa), potassium(ΔK), and hematocrit(ΔHct) before and after Custodiol® infusion was investigated and postoperative neurologic complication of two groups were also compared. Custodiol® was evacuated through right atriotomy or venting catheter insertion at right atrium.
RESULTS:
There was one mortality in group 2. Mean dosage of Custodiol® infusion was 2000cc, and mean dosage of Custodiol® evacuation was 1450cc. There was no significant difference in mean of cardiopulmonary bypass time and aortic cross cramp time between two groups. The concentration of Na and Hct after Custodiol® infusion in group 1 were lower than in group2 (p<0.01). ΔNa and ΔHct were lower in group 2 than in group 1. Need of transfusion (group 1; 81.6%, group 2; 38.5%, p<0.01) and postoperative especially delirium (group 1; 15.5%, group 2; 0, p<0.01) was more common in group 1.
CONCLUSIONS:
Our experiences shows the evacuation of Custodiol® reduce risk of postoperative delirium and need of transfusion by reducing hemodilution during CPB.
Disclosure for ALL authors: None


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