Background and Aim: Cardioplegia is a pharmacological approach essential for heart protection from ischemia–reperfusion injury. Acute kidney injury (AKI) is a serious complication after cardiac surgery. We sought to determine the possible onset of AKI in patients undergoing cardiac surgery with different cardioplegic solution during extracorporeal circulation including Custodiol solution (CS), cold crystalloid St. Thomas extracellular cardioplegia (CCC) and warm blood cardioplegia (WBC). Methods: We retrospectively collected data from 186 patients undergoing cardiac surgery between June 2022 and December 2023. Three groups of patients, based on the above mentioned three different types of cardioplegic solutions administered, were established. We analyzed pH, sodium, potassium, calcium, chlorine, lactates before cardiac surgery (T0), after the first dose of cardioplegic solution infusion (T1) and at the end of cardiopulmonary bypass (CPB) (T2), at 48 hours (T3) and 7 days after cardiac surgery (T4). The severity of renal injury was defined as a creatinine serum increase between 0.3 and 1.9 mg/dl and an increase >/= 2 mg/dl. Results: Preoperative serum creatinine level, lactate level at weaning from cardiopulmonary bypass > 3 mmol/L, sodium level imbalance during CPB, and male gender were statistically significant predictors of AKI in our population. Type of cardioplegia was not detected as an independent risk factor at the multivariate analysis. However, WBC was associated with a significantly higher risk of AKI at the univariate analysis. Conclusions: There is no evidence concluding which could be the safest cardioplegic solution to prevent AKI occurrence.
Associazione Nazionale Medici Cardiologi Ospedalieri
