Reduction of reperfusion injury with mannitol cardioplegia

Abstract Forty consecutive patients undergoing myocardial revascularization were divided into two equal groups: group 1 received standard cardioplegic solution, and group 2 received a solution containing mannitol, 59.8 mmol/L. In 6 patients in each group, myocardial biopsies were done before ischemia and at the time of reperfusion. Samples were assessed by chemiluminescence to determine oxidative stress and by electron microscopic studies. A significant reduction in atrial arrhythmias was observed in the mannitol group. Chemiluminescence in group 1 showed a photoemission of 37.6 ± 3.5 cpm/mg of protein × 10 −3 for the preischemia samples and 74.8 ± 16 cpm/mg of protein × 10 −3 for the reperfusion samples ( p −3 and 40 ± 6.1 cpm/mg of protein × 10 −3 , respectively ( p = not significant). Electron microscopic studies showed, for group 1, increased grades of damaged mitochondria in the reperfusion biopsy specimens compared with the preischemia biopsy specimens ( p