Potassium chloride 6% (potassium 16mmol/20ml) / Magnesium chloride 16.3% (magnesium 16mmol/20ml) / Procaine hydrochloride 280mg solution for cardioplegia 20ml ampoules

BackgroundHyperkalemia is a frequently observed electrolyte imbalance in dehydrated neonatal diarrheic calves that can result in skeletal muscle weakness and life-threatening cardiac conduction abnormalities and arrhythmias.HypothesisIntravenous administration of a small-volume hypertonic NaHCO3 solution is clinically more effective in decreasing the plasma potassium concentration (cK) in hyperkalemic diarrheic calves than hypertonic NaCl or glucose solutions.AnimalsTwenty-two neonatal diarrheic calves with cK >5.8 mmol/L.MethodsProspective randomized clinical trial. Calves randomly received either 8.4% NaHCO3 (6.4 mL/kg BW; n = 7), 7.5% NaCl (5 mL/kg BW; n = 8), or 46.2% glucose (5 mL/kg BW; n = 7) IV over 5 minutes and were subsequently allowed to suckle 2 L of an electrolyte solution. Infusions with NaHCO3 and NaCl provided an identical sodium load of 6.4 mmol/kg BW.ResultsHypertonic NaHCO3 infusions produced an immediate and sustained decrease in plasma cK. Hypertonic glucose infusions resulted in marked hyperglycemia and hyperinsulinemia, but cK remained unchanged for 20 minutes. Between 30 and 120 minutes after initiation of treatment, the most marked decrements in cK from baseline occurred in group NaHCO3 , which were significantly (P 3 , NaCl, and glucose, respectively.Conclusions/clinical importanceSmall-volume hypertonic NaHCO3 infusions appear to have clinical advantages for the rapid resuscitation of hyperkalemic diarrheic calves, compared to hypertonic NaCl or glucose solutions.

Abstract licence: CC BY-NC

IntroductionAcute ruminal impaction is a metabolic disorder of the digestive system that happens in ruminants that have been fed a high amount of cereal grains, negatively impacting animal health and productivity. The present study clarified the diagnostic and prognostic significance of certain clinico-biochemical findings in evaluation of the efficacy of the applied therapeutic regimen in sheep with acute carbohydrate engorgement. This was conducted through monitoring changes in clinical findings, blood pictures, ruminal function biomarkers, serum hepatorenal indicators, and serum electrolytes indices in fattening Osimi sheep on days 0 pre-therapy and days 3, 7, 15, 30, 60, and 90 post-therapy.MethodsThe study comprised fattening non-pregnant Osimi sheep (n = 100) with acute ruminal impaction. They were exposed to a 5-day integrated treatment regimen. It included IV infusion of sodium bicarbonate and glucose, an oral drenching of each of magnesium hydroxide, antibloat preparation (Bloatryal), and laxative powder (Apilax Powder). This was followed by injectable doses of flunixin meglumine, diphenhydramine HCl, clanobutin sodium, broad spectrum antibiotic (Combikel 20 + 20), and doramectin (a broad-spectrum anthelmintic). The investigated sheep had a full clinical examination and hemato-biochemical tests from day 0 (pre-therapy) up to day's 3-90 post-therapy.Results and conclusionThe applied therapeutic regimen (1-5 days' therapeutic program) was highly effective in cases of acute ruminal impaction in sheep, as evidenced by a clear improvement in their clinical health status (up to 15 days post-therapy) as well as restoring their reference intervals of ruminal functions biomarkers, blood picture indices, and hepatorenal functions throughout the current study (15-60 days post-therapy). Except for hepatorenal functions, all estimated laboratory indices restored their physiological intervals on the 15th day post-therapy. A 30- to 60-day follow-up period was required post-therapy until hepatorenal function restored their physiological reference intervals.

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BackgroundDel Nido cardioplegia (DNC) is a single-dose, high potassium, low-volume cardioplegia solution that has grown in favor recently. However, the use of DNC in the Asian population may be associated with certain challenges.MethodsBetween January 2017 and April 2022, DNC was used for myocardial protection in this single-center retrospective study. In total, 5731 patients underwent open heart surgeries, where 310 patients received DNC for single or multiple procedures. A total of 307 pair of propensity-matched patients from DNC and cold blood St. Thomas cardioplegia (STC) were compared.ResultsIn total, 5085 patients with STC and 310 patients with DNC from the cohort were matched, reflecting the initial group sizes before propensity matching. About 307 patient pairs were included in the final analysis after propensity matching with the interest variables. In the STC group, the requirement for an immediate postoperative intra-aortic balloon pump (IABP) was significantly higher [18 (5.9%) in DNC versus 28 (9.1%) in STC, p = 0.021]. A 30-day mortality was comparable between the DNC and STC groups (2.9% versus 3.3%, p = 1.00). Major adverse cardiac events (MACE) (2.6% versus 3.6%, p = 0.648) showed no difference between the groups. In both single and multiple procedure subgroups, there were no statistically significant differences in 30-day mortality and MACE incidences when comparing STC and DNC.ConclusionThe use of DNC in adults is acceptable and adaptable. Comparable clinical outcomes between STC patients and DNC were revealed by our investigation. There were no appreciable differences in 30-day mortality or MACE despite the STC group having a much higher need for immediate postoperative IABP.

Abstract licence: CC BY-NC