{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:09:26Z","timestamp":1784534966651,"version":"3.55.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>del Nido cardioplegia (DC), initially developed for paediatric cardiac surgery, is increasingly used in adult procedures due to its ability to provide prolonged myocardial protection with a single dose. However, its superiority over blood cardioplegia (BC) remains unclear. This study compared the effects of DC and BC on acid\u2013base balance, potassium levels, and metabolic profiles in adults undergoing elective cardiac surgery with cardiopulmonary bypass (CPB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective observational study was conducted at a tertiary care centre over a period of 6 months. Forty-seven patients were divided into Group BC (received blood cardioplegia) and Group DC (received del Nido cardioplegia). Arterial blood gases were recorded at four intraoperative time points. The four time points were T1, baseline before CPB; T2, immediately after cardioplegia administration; T3, post-rewarming just before separation from CPB; and T4, before transfer to the intensive care unit. Statistical analyses were performed using independent t-tests and Chi-square tests, or their equivalent non-parametric alternatives when appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Group DC exhibited a significantly higher potential of hydrogen (pH) (7.49 vs 7.43,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003) and base excess (0.15 vs \u2212 1.80 mmol\/L,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.014) at post-rewarming (T3). Potassium was lower in group DC at baseline (T1). Blood glucose was significantly higher in group BC at T3 (275 vs 207 mg\/dL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and T4 (258 vs 217 mg\/dL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.033). Five patients in the DC group required blood transfusion during CPB.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>DC and BC showed largely comparable intraoperative metabolic and physiological profiles, with most observed differences remaining within acceptable physiological ranges and of limited clinical significance. DC may be a practical alternative to BC; however, larger prospective studies evaluating direct myocardial injury markers and postoperative outcomes are needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1635_25","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:00:24Z","timestamp":1784383224000},"page":"821-828","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of del Nido and blood cardioplegia on metabolic changes and acid\u2013base balance in adult cardiac surgeries under cardiopulmonary bypass"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3566-1517","authenticated-orcid":false,"given":"Prashanth","family":"Chintalapudi","sequence":"first","affiliation":[{"name":"Department of Critical Care, AIG Hospital, Gachibowli, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5181-5993","authenticated-orcid":false,"given":"Syama Sundar","family":"Ayya","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, All India Institute of Medical Sciences Bibinagar, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0702-9597","authenticated-orcid":false,"given":"Akhya Kumar","family":"Kar","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Nizam\u2019s Institute of Medical Sciences, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8489-4675","authenticated-orcid":false,"given":"Dintakurthi Ragha","family":"Renuka","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Mallareddy Medical College for Women, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5782-3716","authenticated-orcid":false,"given":"Gopinath","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, ESIC Medical College, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5670-6929","authenticated-orcid":false,"given":"Praveena","family":"Anyapu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Gitam Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"R1-20260720","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1177\/0267659111409276","article-title":"Myocardial protection during aortic surgery: Comparison between Bretschneider-HTK and cold blood cardioplegia","volume":"26","author":"Scrascia","year":"2011","journal-title":"Perfusion"},{"key":"R2-20260720","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1016\/j.jtcvs.2019.03.125","article-title":"Single-dose cardioplegia protects myocardium as well as traditional repetitive dosing: A noninferiority randomized study","volume":"159","author":"Vivacqua","year":"2020","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R3-20260720","first-page":"717","article-title":"Custodiol for myocardial protection and preservation: A systematic review","volume":"2","author":"Edelman","year":"2013","journal-title":"Ann Cardiothorac Surg"},{"key":"R4-20260720","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1051\/ject\/201244098","article-title":"History and use of del Nido Cardioplegia solution at Boston Children\u2019s Hospital","volume":"44","author":"Matte","year":"2012","journal-title":"J Extra Corpor Technol"},{"key":"R5-20260720","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/j.jtcvs.2023.09.057","article-title":"del Nido versus blood cardioplegia in cardiac surgery: A multicenter analysis of over 40,000 patients","volume":"168","author":"Hawkins","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R6-20260720","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/02676591211031095","article-title":"Del Nido cardioplegia for myocardial protection in adult cardiac surgery: A systematic review and update meta-analysis","volume":"38","author":"Zhai","year":"2023","journal-title":"Perfusion"},{"key":"R7-20260720","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1177\/02184923231209858","article-title":"del Nido versus hematic cardioplegia in minimally invasive aortic valve surgery","volume":"31","author":"Pozzoli","year":"2023","journal-title":"Asian Cardiovasc Thorac Ann"},{"key":"R8-20260720","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/1749-8090-9-23","article-title":"Is crystalloid cardioplegia a strong predictor of intra-operative hemodilution?","volume":"9","author":"G\u00fcnday","year":"2014","journal-title":"J Cardiothorac Surg"},{"key":"R9-20260720","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1007\/s00540-023-03306-0","article-title":"Modified del Nido cardioplegia is associated with low incidence of low main strong ion difference and hyperchloremia in pediatric patients after cardiac surgery","volume":"38","author":"Taka","year":"2024","journal-title":"J Anesth"},{"key":"R10-20260720","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1177\/02676591221075522","article-title":"Network meta-analysis comparing blood cardioplegia, Del Nido cardioplegia and custodiol cardioplegia in minimally invasive cardiac surgery","volume":"38","author":"Chan","year":"2023","journal-title":"Perfusion"},{"key":"R11-20260720","first-page":"ivaf054","article-title":"Buckberg versus Del Nido in isolated aortic valve replacement: A prospective, two-centre, randomized trial","volume":"40","author":"Tauron-Ferrer","year":"2025","journal-title":"Interdiscip Cardiovasc Thorac Surg"},{"key":"R12-20260720","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1053\/j.jvca.2024.12.006","article-title":"Role of del Nido cardioplegia solution in prolonged aortic cross-clamp cardiac surgery: A prospective study","volume":"39","author":"Lin","year":"2025","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R13-20260720","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1177\/02676591251315037","article-title":"Effect of del Nido cardioplegia in patients with reduced left ventricular ejection fraction: A meta-analysis","volume":"40","author":"Yamashita","year":"2025","journal-title":"Perfusion"}],"container-title":["Indian Journal of Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/ija.ija_1635_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T08:00:21Z","timestamp":1784534421000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/ija.ija_1635_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":13,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ija.ija_1635_25","relation":{},"ISSN":["0019-5049","0976-2817"],"issn-type":[{"value":"0019-5049","type":"print"},{"value":"0976-2817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-12-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}