■心肌保护对于成功的心脏手术至关重要,因为它可以防止在手术过程中可能发生的心肌损伤。长期缺氧,没有适当的保护,会导致三磷酸腺苷的消耗,微绒毛丢失,水泡形成,和水肿。库托二醇,德尔尼多,和改良的delNido是单剂量心脏停搏术解决方案,在现代手术中具有公认的安全性和重要性。虽然每个都已经独立评估了患者的预后,有限的研究直接比较它们。本研究旨在通过组织学分析比较它们的心肌保护作用。
■在一项双盲临床试验中,至少90名患者将被随机分配接受三种心脏停搏液中的一种.将在体外循环之前和再灌注后15分钟收集心肌活检。手术,麻醉和灌注技术对所有患者都是相同的,遵循机构的标准协议。
■理想的心脏停搏液不存在,它的选择对外科医生来说仍然具有挑战性。在现代外科实践中,了解这些解决方案的行为以及在诱发心脏骤停期间引起的缺血性组织损伤允许更安全的外科手术。该临床试验的结果可以帮助理解心脏停搏液的行为及其组织效应。因此,通过选择最好的心脏停搏液,缺血性损伤可以最小化,提高这种基本技术在心脏手术中的有效性。这项研究可能有助于在几个机构实施临床方案,旨在选择具有卓越心肌保护功能的解决方案,提高安全性,减少开支。
■巴西临床试验注册中心(ReBEC,http://ensaiosclinicos.gov.br/):RBR-997tqhh。注册日期:1月26日,2022年。
UNASSIGNED: Myocardial protection is crucial for successful cardiac surgery, as it prevents heart muscle damage that can occur during the procedure. Prolonged hypoxia without proper protection can lead to adenosine triphosphate consumption, microvilli loss, blister formation, and edema. Custodiol, del Nido, and modified del Nido are single-dose cardioplegic solutions with proven safety and significance in modern surgery. While each has been independently assessed for patient outcomes, limited research directly compares them. This study aims to compare their myocardial protection using histological analysis.
UNASSIGNED: In a double-blind clinical trial, at least 90 patients will be randomly assigned to receive one of the three cardioplegic solutions. Myocardial biopsies will be collected before cardiopulmonary bypass and 15 minutes after reperfusion. The surgical, anesthetic and perfusion techniques will be the same for all patients, following the Institution\'s standard protocols.
UNASSIGNED: The ideal cardioplegic solution does not exist, and its selection remains challenging for surgeons. In modern surgical practice, understanding the behavior of these solutions and the ischemic tissue damage caused during induced cardiac arrest allows for safer surgical procedures. The results of this clinical trial can help in understanding the behavior of cardioplegic solutions and their tissue effects. Thus, by selecting the best cardioplegic solution, ischemic damage can be minimized, enhancing the effectiveness of this essential technique in cardiac procedures. The study may aid in implementing clinical protocols in several institutions, aiming to choose the solution with a superior myocardial protection profile, increasing safety, and reducing expenses.
UNASSIGNED: Brazilian Clinical Trials Registry (ReBEC, http://ensaiosclinicos.gov.br/): RBR-997tqhh. Registered: January 26th, 2022.