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- Title
Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate--a retrospective study.
- Authors
Lindner, Gregor; Zapletal, Bernhard; Schwarz, Christoph; Wisser, Wilfried; Hiesmayr, Michael; Lassnigg, Andrea
- Abstract
<bold>Background: </bold>Hyponatremia is the most common electrolyte disorder in hospitalized patients and is known to be associated with increased mortality. The administration of antegrade single-shot, up to two liters, histidine-tryptophane-ketoglutarate (HTK) solution for adequate electromechanical cardiac arrest and myocardial preservation during minimally invasive aortic valve replacement (MIAVR) is a standard procedure. We aimed to determine the impact of HTK infusion on electrolyte and acid-base balance.<bold>Methods: </bold>In this retrospective analysis we reviewed data on patient characteristics, type of surgery, arterial blood gas analysis during surgery and intra-/postoperative laboratory results of patients receiving surgery for MIAVR at a large tertiary care university hospital.<bold>Results: </bold>A total of 25 patients were included in the study. All patients were normonatremic at start of surgery. All patients developed hyponatremia after administration of HTK solution with a significant drop of serum sodium of 15 mmol/L (p < 0.01). Measured osmolality did not change during all times of surgery compared to start of surgery (p = 0.28 - p = 0.79), indicating isotonic hyponatremia. After administration of HTK solution pH fell significantly due to development of metabolic acidosis.<bold>Conclusions: </bold>Acute hyponatremia during cardioplegia with HTK solution is isotonic and should probably not be corrected without presence of hypotonicity as confirmed by measurement of serum osmolality.
- Publication
Journal of Cardiothoracic Surgery, 2012, Vol 7, Issue 1, p52
- ISSN
1749-8090
- Publication type
journal article
- DOI
10.1186/1749-8090-7-52