Abstract
To assess the potential benefit of hyperosmolar reperfusion induced by mannitol administration in hearts subjected to prolonged global ischemia, 24 canine preparations were subjected to 45 minutes of hypothermic (27°C) cardioplegic arrest and normothermic reperfusion. The hearts were isolated in situ after cardiopulmonary bypass was initiated and control left ventricular function was assessed (developed pressure and dP/dt), and coronary blood flow (CBF) and intramyocardial gas tensions were measured. The hearts were divided into three equal groups: hearts in group 1 received no mannitol during reperfusion; hearts in group 2 received sufficient mannitol to elevate reperfusate osmolarity 35 mosmol from the onset of reperfusion; and hearts in group 3 received a similar quantity of mannitol beginning 15 minutes after the onset of reperfusion. Immediate hyperosmolar reperfusion in group 2 resulted in a significantly greater CBF at 5 minutes (224 ± 14% control vs 142 ± 14% control in group 1), with a higher endocardial/epicardial flow ratio (1.24 ± 0.09 vs 0.94 ± 0.11 in group 1) and better-preserved left ventricular function after 45 minutes (90 ± 2% control vs 79 ± 3% in group 1 and 80 ± 2% in group 3). In addition, both group of mannitol treated hearts had significantly less formation of myocardial edema and improved structural preservation compared with the non-mannitol-treated hearts. These data confirm the benefits of hyperosmolar, postischemic reperfusion with mannitol and suggest that administration of mannitol at the onset of reperfusion results in improved myocardial protection.
| Original language | English (US) |
|---|---|
| Pages (from-to) | I-34-I-41 |
| Journal | Circulation |
| Volume | 62 |
| Issue number | 2 II |
| State | Published - Oct 10 1980 |
| Externally published | Yes |
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)