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Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study
BACKGROUND: 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 a...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430602/ https://www.ncbi.nlm.nih.gov/pubmed/22681759 http://dx.doi.org/10.1186/1749-8090-7-52 |
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author | Lindner, Gregor Zapletal, Bernhard Schwarz, Christoph Wisser, Wilfried Hiesmayr, Michael Lassnigg, Andrea |
author_facet | Lindner, Gregor Zapletal, Bernhard Schwarz, Christoph Wisser, Wilfried Hiesmayr, Michael Lassnigg, Andrea |
author_sort | Lindner, Gregor |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. |
format | Online Article Text |
id | pubmed-3430602 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34306022012-08-30 Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study Lindner, Gregor Zapletal, Bernhard Schwarz, Christoph Wisser, Wilfried Hiesmayr, Michael Lassnigg, Andrea J Cardiothorac Surg Research Article BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. BioMed Central 2012-06-10 /pmc/articles/PMC3430602/ /pubmed/22681759 http://dx.doi.org/10.1186/1749-8090-7-52 Text en Copyright ©2012 Lindner et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Lindner, Gregor Zapletal, Bernhard Schwarz, Christoph Wisser, Wilfried Hiesmayr, Michael Lassnigg, Andrea Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
title | Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
title_full | Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
title_fullStr | Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
title_full_unstemmed | Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
title_short | Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
title_sort | acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate – a retrospective study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430602/ https://www.ncbi.nlm.nih.gov/pubmed/22681759 http://dx.doi.org/10.1186/1749-8090-7-52 |
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