Does pH-Stat Provide Better Protection?
Background Cardiac troponin-T is a sensitive marker of myocardial damage. In a prospective study, the effect of 2 different pH strategies during cardiopulmonary bypass on ischemic myocardial injury and clinical outcome was measured in a pediatric population. Methods and Results One hundred one patients (31 neonates 13.2±8.3 days and 70 children 34.5±44.1 months of age) undergoing open-heart surgery were selected to either -stat (n=51) or pH-stat (n=50) acid-based management protocol. Serum troponin-T levels were measured before and 30 minutes after bypass and then 4 and 24 hours postoperatively. Surgical procedure, bypass details, inotropic support requirement, and postoperative recovery were recorded. Baseline troponin-T level was higher in neonates than in children (0.18±0.22 versus 0.04±0.05 µg/L, P=0.02). Also, a higher baseline level was found in patients with pulmonary hypertension (0.13±0.21 versus 0.04±0.05 µg/L, P=0.04). Cyanotic children showed a higher peak troponin-T level
