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March 1979

Subendocardial Protection During Cardiopulmonary BypassIts Use With Methylprednisolone and Glucose-Insulin-Potassium

Author Affiliations

From the Division of Cardiothoracic Surgery, University of Rochester Medical Center, Rochester, NY.

Arch Surg. 1979;114(3):302-304. doi:10.1001/archsurg.1979.01370270072012

• Fifteen adult dogs were equally divided into three groups: group 1 (control) received no medication before or after cardiopulmonary bypass (CPB), group 2 was administered glucose-insulin-potassium (GIK) according to Maroko's protocol before, during, and after CPB, whereas group 3 was treated with methylprednisolone (30 mg/kg) 30 minutes prior to and near the end of CPB. Moderately severe subendocardial hemorrhage was present in 80% of group 1, 50% of group 2, and only 20% of group 3 ventricles. Endocardial viability ratios after CPB were greater than 0.75 in 20% of group 1, 80% of group 2, and 100% of group 3 animals.

Both GIK and steroids improved subendocardial perfusion after anoxic arrest and CPB compared with controls. However, steroid-treated dogs exhibited less endocardial hemorrhage, improved contractility, and more rapid return to baseline conditions than either GIK or control animals. These data suggests that steroids could be considered whenever normothermic anoxic cardiac arrest is used for cardiac operations.

(Arch Surg 114:302-304, 1979)