HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Richard P. Embrey Ralph J. Damiano, Jr Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Danetz, J. S. Articles by Baumgarten, C. M. Search for Related Content PubMed PubMed Citation Articles by Danetz, J. S. Articles by Baumgarten, C. M.

J Thorac Cardiovasc Surg 1999;118:467-476
© 1999 Mosby, Inc.

CARDIOPULMONARY SUPPORT AND PHYSIOLOGY

AGE-RELATED EFFECTS OF ST THOMAS’ HOSPITAL CARDIOPLEGIC SOLUTION ON ISOLATED CARDIOMYOCYTE CELL VOLUME

Supported by National Institutes of Health grants HL-09817 (J.S.D., C.M.B.) and HL-46764 (C.M.B.).

Address for reprints: Clive M. Baumgarten, PhD, Department of Physiology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA 23298-0551 (E-mail: baumgart{at}hsc.vcu.edu).

Objectives: We tested the hypothesis that neonatal cells are more sensitive to cardioplegia-induced cell swelling than more mature cells and spontaneous swelling in the absence of ischemia can be prevented by cardioplegia with a physiologic KCl product.
Methods: Cell volumes of isolated ventricular myocytes from neonatal (3-5 days), intermediate (10-13 days), and adult (>6 weeks) rabbits were measured by digital video microscopy. After equilibration in 37°C physiologic solution, cells were suprafused with 37°C or 9°C St Thomas’ Hospital solution (standard or low Cl^–) or 9°C physiologic solution followed by reperfusion with 37°C physiologic solution.
Results: Neonatal cells swelled 16.2% ± 1.8% (P < .01) in 37°C St Thomas’ Hospital solution and recovered during reperfusion, whereas more mature cells maintained constant volume. In contrast, 9°C St Thomas’ Hospital solution caused significant age-dependent swelling (neonatal, 16.8% ± 1.5%; intermediate, 8.6% ± 2.1%; adult, 5.6% ± 1.1%). In contrast to more mature cells, neonatal cells remained significantly edematous throughout reperfusion (8.1% ± 1.5%). Swelling was not due to hypothermia because 9°C physiologic solution did not affect volume. Lowering the KCl product of St Thomas’ Hospital solution by partially replacing Cl^– with an impermeant anion prevented cellular edema in all groups.
Conclusion: In the absence of ischemia, neonatal cells were more sensitive to cardioplegia-induced cellular edema than more mature cells, and edema observed in all groups was avoided by decreasing the KCl product of St Thomas’ Hospital solution to the physiologic range. Differences in cell volume regulation may explain the sensitivity of neonatal hearts to hyperkalemic cardioplegic arrest and suggest novel approaches to improving myocardial protection.

This article has been cited by other articles:

				J. S. Danetz, R. D. Davies, H. F. Clemo, and C. M. Baumgarten RABBIT VENTRICULAR MYOCYTE VOLUME CHANGES AS A DIRECT RESULT OF CRYSTALLOID CARDIOPLEGIA IN CONGESTIVE HEART FAILURE INDUCED BY AORTIC REGURGITATION J. Thorac. Cardiovasc. Surg., April 1, 2000; 119(4): 826 - 833. [Abstract] [Full Text] [PDF]