Combined cardiac arrest preserving fluid, preparation method and application thereof

Abstract

The invention discloses a combined cardiac arrest preserving fluid, comprising St. Thomas fluid and hemoglobin-based oxygen carriers. The fluid can be prepared into a commercial cardiac arrest preserving fluid finished product for sale, or the St. Thomas fluid and the hemoglobin-based oxygen carriers are respectively packaged independently for preparation before use. The cardiac arrest preserving fluid has the advantages of safety and efficiency, simple operation and convenient use, and is mainly used for cardiac arrest and protection in extracorporeal circulation operation.

Description

technical field [0001] The invention relates to a cardioplegia preservation solution, in particular to a combined cardioplegia preservation solution for cardiac arrest and protection during surgical operations. Background technique [0002] Cardiac events are the most important cause of severe complications and death in patients during the perioperative period. Cardiopulmonary bypass surgery directly acts on the heart and is a major cause of cardiac events. Although the use of traditional cardioplegia preservation solution makes it safer and more effective for surgeons to perform operations related to extracorporeal circulation, it will still cause a certain degree of damage to the heart after extracorporeal circulation. First of all, cardiac arrest for cardiac surgery patients will damage the myocardium due to cardiac ischemia-reperfusion injury, resulting in poor prognosis. Second, adverse effects associated with cardiopulmonary bypass can lead to persistent cardiac dysfu...

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Problems solved by technology

[0003] At present, although St.Thomas solution is still the classic cardiac arrest preservation solution for extracorporeal circulation-related operations, there are still many problems in the use of St.Thomas solution

First of all, in the process of cardiac arrest, St.Thomas solution cannot provide oxygen to the ischemic and hypoxic myocardium, so it will inevitably cause ischemia-reperfusion injury

Secondly, although the blood-containing cardioplegia preservation solution is widely used now, and there are a large number of documents pointing out that it is better than the simple crystalloid cardioplegia preservation solution, there are still problems, such as (1) the blood of patients with malignant tumors and blood diseases is due to clinical For security reasons, it cannot be used directly

(2) Due to the use of a large amount of priming fluid during extracorporeal circulation, the blood is greatly diluted, so its oxygen-carrying capacity has been greatly reduced. At the same time, the patient's body temperature is appropriately lowered during extracorporeal circulation, which will also affect the blood flow. Oxygen-carrying and oxygen-releasing capacity, thereby impairing the cardioprotective effect of hemoplegic preservation solutions

(3) In cardiopulmonary bypass surgery, the preparation of blood-containing cardioplegia preservation solution needs to divert the patient's blood, which increases the work of surgeons and transfer personnel

[0004] There have been reports on the use of cardioplegia containing polyethylene glycol-bovine hemoglobin to preserve isolated hearts (Chang Xin, Chinese Journal of Thoracic and Cardiovascular Surgery, Volume 15, Issue 4, August 2008, P277-280), but There are still deficiencies in the protection of the stopped heart in cardiopulmonary bypass surgery, such as: (1) The isolated heart perfusion model selected in this study cannot show the protective effect of cardiac arrest in cardiopulmonary bypass surgery due to the lack of systemic immune system and humoral regulation. Response of somatic heart to ischemia-reperfusion injury

(2) This study only mixed polyethylene glycol-bovine hemoglobin and St.Thomas solution, and did not add antioxidants and adjust pH.

The inventors have confirmed in research that simply mixing hemoglobin oxygen-carrying carriers (HBOCs) with St.Thomas solution can indeed exert an effective protective effect on the isolated heart, but the protective effect on the in vivo heart in cardiopulmonary bypass surgery Therefore, in order to improve the safety of implementing extracorporeal circulation, improve the prognosis of patients, reduce the extra work of medical staff, and devote more energy to intraoperative operations, it is urgent to develop an oxygen-carrying capacity for extracorporeal circulation Cardiac arrest preservation solution with good protective effect for cardiac arrest during operation

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