A comparison of the effects of histidin-tryprtophan-ketoglutarate and conventional crystalloid cardioplegia solutions on myocardial protection during pediatric cardiac surgery [Pediyatrik kardiyak cerrahide histidin-triptoian-ketoglutarat ve geleneksel kristalloid kardiyopleji solüsyonlarinin miyokardiyal koruma üzerine etkilerinin karşilaştirilmasi]

Objective: the aim of this study is to compare the effects ofhistidin-tryprtophan-ketoglutarate and conventional crystalloid cardioplegia on release of cardiac troponin-i (ctn-i) and creatinekinase-myocardial band (ck-mb) which are perioperative determinants of myocardial protection. method: sixty-six children aged 1 month to 6 years undergoing elective congenital heart surgery were randomised into two groups. after aortic cross-clamping the groups receieved htk solütion (group h,n=32) or crystalloid cardioplegia (group k,n=34)for cardioplegic induction. blood samples for ctn-i and ck-mb levels were measured before the surgical incision,at the end of surgery and on 4th,16th,24th and 48th hours postoperatively. patients' intraoperative and postoperative maximum inotropic drug requirements,amounts of blood and fluids used,urine output,hemodynamic parameters,levels of ctn-i and ck-mb and duration of mechanical ventilation,lengths of intensive care unit (icu) and hospital stay were recorded. results: demographic features were similar in both groups. duration of surgery,aortic clamp and cardiopulmonary bypass (cpb) times,amounts of intraoperative fluids used and urine outputs were similar between the groups. the groups were not significantly different in terms of ctn-i and ck-mb levels at the end of surgery and postoperative period (p>0.05 forall). duration of mechanical ventilation,lengths of icu and hospital stay were similar in both groups (p>0.05for all). conclusion: htk and crystalloid cardioplegia solutions are not superior to the other for myocardial protection during pediatric cardiac surgery. larger studies including complex pediatric cardiac surgeries are needed to better understand the effects of htk solution on myocardial protection in pediatric patients.