Self-constituted modified del Nido cardioplegia solution in pediatric congenital heart defect surgery.

Abstract

ABSTRACT… Objective: To present our experience of modified del Nido Cardioplegia for chemical arrest and myocardial protection during congenital heart defect in pediatric cardiac surgeries. Study Design: Retrospective Cross Sectional. Setting: Department of Cardiac Surgery, PAQSJIMS, Gambat, Khairpur. Period: 15^th March, 2021 to 10^th October, 2022. Material & Methods: del Nido solution is generally constituted in plasma lyte A solution, not available in Pakistan; therefore, we constituted del Nido solution in ringer lactate solution. We had collected our data retrospectively for our study to assess the safety and efficacy of modified del Nido cardioplegic arrest during the open heart surgeries for congenital heart defects. We report clinical outcomes of our patients that include spontaneous rhythm, ionotropic score and duration of mechanical ventilation underwent open heart surgeries with. Results: During the study period we had performed 102 surgeries for correction or palliation of congenital heart defects. We have included 54 patients in our study co with 28 (52%) male and 26 female (48%) patients; had a mean age 8.9 (±3.7) years and mean weight 22.4 (±12.7) kg. Majority of patients 29 (54%) belonged to Category 2 on RACHS-1 scale. Our average cross clamp time was 39.7min, and 37(68%) patients required a single dose of cardioplegia. Spontaneous sinus rhythm was established in 48(89%) patients; average ionotropic score of patients at the time of PICU arrival was 8.6 (±5.6) with 31(57%) have score of less than 10, while 2(4%) patients were received without the ionotrope. All the patients were shifted on mechanical ventilators with average time of 253.6 (±219.6) min of mechanical ventilation. Conclusion: Our results show modified del Nido solution is safe, with added benefits of fewer interruption in surgery, greater magnitude of spontaneous sinus rhythm and fewer ionotropic requirements.