Fructose-1,6-diphosphate (FDP) is used to treat patients who are undergoing coronary 
artery bypass grafting (CABG) 
surgery. Before 
cardiopulmonary bypass begins, a liquid that contains FDP is intravenously infused in the patient, preferably for about 10 to 30 minutes, to allow the FDP to enter the heart and 
lung tissue while the heart is still beating. FDP can also be added to cardioplegia solution; in addition, FDP can be injected after bypass is terminated, but if post-bypass injection is used, steps should be taken to avoid excess 
lactic acid accumulation, which appears to increase the risk of 
atrial fibrillation. To prevent or control lactic 
acidosis, a buffering or 
alkalizing agent, such as 
sodium bicarbonate, or an agent which reduces 
lactic acid formation, such as dichloroacetate, can be used. In double-blinded trials, this use of FDP substantially reduced heart damage and improved overall outcomes, as shown by lower levels of 
creatine kinase in blood, improvements in pumping performance, reduced requirements for vasodilator and inotropic drugs, and shorter stays in 
intensive care units. Certain dosages also reduced the likelihood of 
atrial fibrillation; however, FDP at high dosages increased the likelihood of A-fib. FDP also helped reduce pulmonary 
vascular resistance (PVR); this is an important finding, since 
pulmonary hypertension following 
cardiopulmonary bypass is a very difficult and often intractable problem, and is a contributing factor in nearly all deaths following CPB 
surgery.