As I have mentioned in a previous blog, I have been getting more comfortable with using Del Nido Cardioplegia.
I have enclosed the components that we utilize.
We use a 4:1, blood: cardioplegia ratio
I believe that it has been described using a 1:4 ratio.
I usually deliver a 2 liter induction dose and then I give an additional 500cc , 45-55 minutes later.
I would recommend not giving an additional dose within 20 minutes of unclamping because I have noticed that the heart is a bit more stunned and takes longer to resume electrical activity.
1 liter of Plasmalyte or Isolyte or Normasol
Mannitol 20% 16 mL
Magnesium 2 g 4 mL
KCL 35 mEq
Sodium Bicarbonate 13 mL
Lidocaine 2% 6.5 mL
I usually end up using approximately 2 liters of this cardioplegia because I also utilize this solution to irrigate the aortic root and LV after debriding the calcium or for testing my mitral valve repair.
We have been using Del Nido for over two years now in our adult population. I am curious if you started using it with a 1:4 ratio then changed to 4:1.
I have never used the 1:4.
I have always used the 4:1 and it seems to work great. I give a 2 liter initial arrest dose and feel comfortable now for up to 60-70 minutes.