CN109248173A - A kind of cardioplegic solution - Google Patents
A kind of cardioplegic solution Download PDFInfo
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- CN109248173A CN109248173A CN201811407410.2A CN201811407410A CN109248173A CN 109248173 A CN109248173 A CN 109248173A CN 201811407410 A CN201811407410 A CN 201811407410A CN 109248173 A CN109248173 A CN 109248173A
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/045—Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates
- A61K31/047—Hydroxy compounds, e.g. alcohols; Salts thereof, e.g. alcoholates having two or more hydroxy groups, e.g. sorbitol
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- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/16—Amides, e.g. hydroxamic acids
- A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
- A61K31/167—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide having the nitrogen of a carboxamide group directly attached to the aromatic ring, e.g. lidocaine, paracetamol
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- A61K33/06—Aluminium, calcium or magnesium; Compounds thereof, e.g. clay
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- A61K33/00—Medicinal preparations containing inorganic active ingredients
- A61K33/14—Alkali metal chlorides; Alkaline earth metal chlorides
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- A61K35/12—Materials from mammals; Compositions comprising non-specified tissues or cells; Compositions comprising non-embryonic stem cells; Genetically modified cells
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- A61K9/0012—Galenical forms characterised by the site of application
- A61K9/0019—Injectable compositions; Intramuscular, intravenous, arterial, subcutaneous administration; Compositions to be administered through the skin in an invasive manner
- A61K9/0026—Blood substitute; Oxygen transporting formulations; Plasma extender
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Abstract
A kind of cardioplegic solution, it is the Plasma-Lyte A to imitate extracellular fluid©(Multiple electrolytes injection, Bomaili A) solution is as matrix solution, every 1000ml matrix solution contains 20% 16-17ml of mannitol simultaneously, 25% 7.5-8.5ml of magnesium sulfate, 5% sodium bicarbonate 10-12ml, 10% potassium chloride 13.5-16.5ml, 2% 6-7ml of lidocaine, above-mentioned crystal is mixed by the volume fraction of 1:4 with self oxygenated blood and constitutes Blood cardioplegia, final potassium ion (K+) working concentration are as follows: 11.8-13.5 mmol/L；It has the damage that can solve crystal overload in the short time, mitigation high concentration K+ to ischemic myocardium, and reliable effective, single infusion can maintain stop the features such as fighting for a long time for 60-90 minutes.
Description
Technical field
The present invention relates to a kind of cardioplegic solution, it is mainly used for minimally invasive cardiovascular surgical procedure under general anesthesia extracorporal circulatory system
When cardiac arrest during myocardial preservation, belong to raising and guarantee of the medical safety technical field.
Background technique
Human adult heart cardioplegic solution is many kinds of at present, respectively there is advantage and disadvantage, but there is no and generally acknowledge optimal myocardial preservation scheme.Face
Generally according to the Buckberg agreement that the nineties in last century establishes on bed, using 4: 1 Blood cardioplegia discontinuous infusions, it is possible to provide fill
The substrate and oxygen of foot simultaneously take away metabolite, and Myocardial protective effects are definite.But the frequency that its every 20-30min is filled again, influences to perform the operation
Continuity, and repeatedly there are damage cardio-vascular endothelial cells, the aggravation unfavorable factors such as myocardial edema in perfusion.With angiocarpy
Surgery especially minimal invasive techniques flourish, and the simplicity of cardioplegic solution management application becomes new demand, that is, seek one kind
The cardioplegic solution of reliable and effective single infusion.
Brettschneider liquid (Custodial-HTK liquid) meets single infusion Myocardial protective effects and reliably stablizes,
But in the application of adult department of cardiovascular surgery, there are still some problems, such as causes short time a large amount of crystalloid fluids to enter circulation, after perfusion
The doubt of hyponatremia, and there are problems that how coronary stenosis patient guarantees that cardioplegic solution is uniformly perfused.The nineties in last century,
The del Nido cardioplegic solution that research team of Univ. of Pittsburgh develops also meets single infusion and Myocardial protective effects are full
It is intended to infant myocardium protection field to be widely used.At present in North America, there are more and more del Nido liquid to be used for adult
Successful experience report, imitate it the physiological property and powerful cardiac muscle cell's membrane stabilizing action of extracellular fluid, contain with existing 4:1
Price similar in blood cardioplegic solution is even more clinical popular.But in adult department of cardiovascular surgery application process, it has been found that one
A little problems, such as adhering to single infusion still for the Ischemic Cardiomyopathy there are coronary stenosis there be no evidence to suggest its safety；
And since 800ml is crystalloid fluid in adult's perfusion total amount 1L, also bring the problem that the crystal load short time is overweight；There are also del
Potassium ion (K+) concentration is 24mmol/L in Nido liquid, constitutes the potential threat of high potassium damage to cardiac muscle.
Therefore, small to meet adult minimal invasive cardiac surgery visual area, exposure is poor；The aorta clamping time extends, and is perfused repeatedly
Blood cardioplegia influence the problems such as visual area make cardioplegic solution can reliable and effective single infusion become adult heart surgical department
One proposition.
Summary of the invention
It is an object of the invention to overcome the shortcomings of the prior art, and one kind is provided can to solve in the short time crystal negative
Lotus is overweight, mitigates damage of the high concentration K+ to ischemic myocardium, and reliable and effective, single infusion can maintain 60-90 minutes long-times
The cardioplegic solution of myocardial preservation.
The object of the present invention is achieved by the following technical solutions, a kind of cardioplegic solution, it is with imitative extracellular
The Plasma-Lyte A of liquid©For (Multiple electrolytes injection, Bomaili A) solution as matrix solution, every 1000ml matrix is molten
Liquid contains 20% mannitol 16-17ml simultaneously, 25% magnesium sulfate 7.5-8.5ml, 5% 10-12ml of sodium bicarbonate, 10% potassium chloride
13.5-16.5ml, 2% 6-7ml of lidocaine, above-mentioned crystal mix composition containing blood by the volume fraction of 1:4 with self oxygenated blood
Cardioplegic solution, final potassium ion (K+) working concentration are as follows: 11.8-13.5mmol/L.
As preferred: every 1000ml matrix solution contains 20% mannitol 16.3ml, 25% magnesium sulfate 8ml, 5% carbonic acid simultaneously
Hydrogen sodium 11ml, 10% potassium chloride 15ml, 2% lidocaine 6.5ml, above-mentioned crystal and self oxygenated blood are mixed by 1: 4 volume fraction
Close the cold crystal Blood cardioplegia for constituting temperature between 8-12 DEG C, final potassium ion (K+) working concentration are as follows: 12.6
mmol/L。
The invention belongs to the improvement to the prior art, crystal overload in the short time can be solved, mitigate high concentration K by having
+ the damage to ischemic myocardium, reliable effective, single infusion can maintain stop the features such as fighting for a long time for 60-90 minutes.
Specific embodiment
Below in conjunction with specific embodiment, the present invention will be described in detail: a kind of cardioplegic solution of the present invention is
Del Nido liquid is improved, is the Plasma-Lyte A to imitate extracellular fluid©(Multiple electrolytes injection, Bomaili A) solution
As matrix solution, every 1000ml matrix solution contains 20% mannitol 16-17ml simultaneously, 25% magnesium sulfate 7.5-8.5ml, and 5%
Sodium bicarbonate 10-12ml, 10% potassium chloride 13.5-16.5ml, 2% 6-7ml of lidocaine, above-mentioned crystal and self oxygenated blood
Blood cardioplegia, final potassium ion (K+) working concentration are as follows: 11.8-13.5 mmol/ are constituted by the volume fraction mixing of 1:4
L。
Embodiment 1: the present invention is the Plasma-Lyte A to imitate extracellular fluid©(Multiple electrolytes injection, vigorous arteries and veins power
A) solution is as matrix solution, and every 1000ml matrix solution contains 20% mannitol 16.3ml, 25% magnesium sulfate 8ml, 5% carbon simultaneously
Sour hydrogen sodium 11ml, 10% potassium chloride 15ml, 2% lidocaine 6.5ml, above-mentioned crystal and self oxygenated blood press 1: 4 volume fraction
Mixing constitutes cold crystal Blood cardioplegia of the temperature between 8-12 DEG C, final potassium ion (K+) working concentration are as follows: 12.6
mmol/L。
Embodiment 2: the present invention is the Plasma-Lyte A to imitate extracellular fluid©(Multiple electrolytes injection, vigorous arteries and veins power
A) solution is as matrix solution, and every 1000ml matrix solution contains 20% mannitol 16ml, 25% magnesium sulfate 7.5ml, 5% carbon simultaneously
Sour hydrogen sodium 10ml, 10% potassium chloride 13.5ml, 2% lidocaine 6ml, above-mentioned crystal is with self oxygenated blood by the volume fraction of 1:4
Mixing constitutes Blood cardioplegia, final potassium ion (K+) working concentration are as follows: 11.8mmol/L.
Embodiment 3: the present invention is the Plasma-Lyte A to imitate extracellular fluid©(Multiple electrolytes injection, vigorous arteries and veins power
A) solution is as matrix solution, and every 1000ml matrix solution contains 20% mannitol 17ml, 25% magnesium sulfate 8.5ml, 5% carbon simultaneously
Sour hydrogen sodium 12ml, 10% potassium chloride 16.5ml, 2% lidocaine 7ml, above-mentioned crystal is with self oxygenated blood by the volume fraction of 1:4
Mixing constitutes Blood cardioplegia, final potassium ion (K+) working concentration are as follows: 13.5 mmol/L.
The cardioplegic solution of the invention, including the Plasma-Lyte A to imitate extracellular fluid©(compound electrolyte
Injection, Bomaili A) solution is matrix solution, containing mannitol, magnesium sulfate, sodium bicarbonate, potassium chloride, lidocaine ingredient,
Above-mentioned crystal is mixed the Blood cardioplegia constituted by 1: 4 volume fraction with self oxygenated blood；Terminal potassium ion (K+) concentration is
12.6 mmol/L mitigate superelevation potassium to myocardium potential damage；Do not change original perfusion system pipeline pipeline when use, it can be with
Keep brilliant: blood ratio is 1:4；Avoid crystal overload in the short time；Single infusion can maintain 60-90 minutes cardiac muscles for a long time
Protection.
Application method are as follows: 1, dosage: inducing cardioplegia dosage is 2000ml for the first time, can maintain 90 minutes myocardial preservations
Effect；Perfusion maintenance dose is 400ml again if necessary, and interval time is 60 minutes.2, reperfusion mode: with self oxygenated blood
By crystalline substance: the volume fraction of blood 1: 4 is irrigated.3, filling temperature: it is advisable between 8-12 DEG C.
Claims (2)
1. a kind of cardioplegic solution, it is the Plasma-Lyte A to imitate extracellular fluid©(Multiple electrolytes injection, vigorous arteries and veins
Power A) solution is as matrix solution, it is characterised in that: every 1000ml matrix solution contains 20% mannitol 16-17ml simultaneously, and 25%
Magnesium sulfate 7.5-8.5ml, 5% sodium bicarbonate 10-12ml, 10% potassium chloride 13.5-16.5ml, 2% 6-7ml of lidocaine, on
It states crystal and mixes composition Blood cardioplegia, final potassium ion (K+) working concentration by the volume fraction of 1:4 with self oxygenated blood
Are as follows: 11.8-13.5 mmol/L.
2. cardioplegic solution according to claim 1, it is characterised in that: it is sweet that every 1000ml matrix solution contains 20% simultaneously
Reveal the sodium bicarbonate of alcohol 16.3ml, 25% magnesium sulfate 8ml, 5% 11ml, 10% potassium chloride 15ml, 2% lidocaine 6.5ml, above-mentioned crystal
The cold crystal Blood cardioplegia for constituting temperature between 8-12 DEG C is mixed by 1: 4 volume fraction with self oxygenated blood, it is final
Potassium ion (K+) working concentration are as follows: 12.6 mmol/L.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811407410.2A CN109248173A (en) | 2018-11-23 | 2018-11-23 | A kind of cardioplegic solution |
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811407410.2A CN109248173A (en) | 2018-11-23 | 2018-11-23 | A kind of cardioplegic solution |
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| CN109248173A true CN109248173A (en) | 2019-01-22 |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113975377A (en) * | 2020-07-27 | 2022-01-28 | 成都青山利康药业有限公司 | Cardioplegia solution |
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| CN104857021A (en) * | 2015-04-30 | 2015-08-26 | 王涛 | Cold autologous blood cardioplegia solution and preparation method and application thereof |
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2018
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Patent Citations (6)
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| CN104107431A (en) * | 2006-05-29 | 2014-10-22 | 低温药理有限公司 | Improved tissue maintenance |
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| US20160158280A1 (en) * | 2013-07-17 | 2016-06-09 | Hibernation Therapeutics, A Kf Llc | A method for organ arrest, protection and preservation and reducing tissue injury |
| CN104857021A (en) * | 2015-04-30 | 2015-08-26 | 王涛 | Cold autologous blood cardioplegia solution and preparation method and application thereof |
| CN104922059A (en) * | 2015-05-21 | 2015-09-23 | 北京青藤谷禧干细胞科技研究院有限公司 | Umbilical cord mesenchymal stem cell injection and preparation method and application thereof |
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Non-Patent Citations (5)
| Title |
|---|
| KANTATHUT NARONGRIT等: "Experience in the use of Del Nido cardioplegia in ramathibodi Hospital", 《JOURNAL OF THE MEDICAL ASSOCIATION OF THALIAND》 * |
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Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN113975377A (en) * | 2020-07-27 | 2022-01-28 | 成都青山利康药业有限公司 | Cardioplegia solution |
| CN113975377B (en) * | 2020-07-27 | 2023-11-10 | 成都青山利康药业股份有限公司 | Cardioplegia solution |
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