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Peer-reviewedCC BY 4.0Brazilian Journal of Cardiovascular Surgery

The Effect of Adding Dexmedetomidine to Modified Del Nido Cardioplegia Solution on Myocardial Protection in Children Undergoing Congenital Heart Defect Surgery - A Prospective, Randomized, Triple-Blind, Controlled Trial

  • Farhad Samadieh1
  • Mahmood Hosseinzadeh Maleki2
  • Masoud Razeghian3
  • Tahereh Izanlou1
  • Mohammadreza Naghibi Sistani4
  • Benyamin Fazli5
  • Mohsen Yaghubi6
6 affiliations
  1. 1Department of Extra-Corporeal Circulation (ECC), Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
  2. 2Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
  3. 3Department of General Surgery, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
  4. 4Pediatric and Congenital Cardiology Division, Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  5. 5Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  6. 6Department of Extra-Corporeal Circulation (ECC), Razavi Hospital, Imam Reza International University, Mashhad, Iran
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Abstract

Introduction: The myocardial ischemia-reperfusion injury (IRI) is an indispensable factor in pediatric congenital heart defect (CHD) surgery. Although effective myocardial protection strategies are crucial, the issue remains a dilemma. This study aimed to evaluate the effect of adding dexmedetomidine to modified Del Nido cardioplegia on myocardial protection in children undergoing CHD surgery.

Methods: This was a prospective, randomized, triple-blind, controlled clinical trial. A total of 60 pediatric patients were enrolled and randomized 1:1 into two groups - an intervention group that received dexmedetomidine-enriched modified Del Nido cardioplegia and a control group that received standard modified Del Nido cardioplegia with normal saline. Primary outcomes included serum troponin I and creatine kinase-MB levels, as well as coronary sinus lactate levels. Secondary outcomes were the vasoactive-inotropic score, weaning time from mechanical ventilation, and intensive care unit length of stay.

Results: Adding dexmedetomidine to modified Del Nido cardioplegia significantly improved myocardial protection in children undergoing CHD surgery. The intervention group showed significantly lower troponin I levels at all postoperative time points compared to the control group (P < 0.001). Similarly, the dexmedetomidine group had significantly lower vasoactive-inotropic score at all time points (P < 0.001). Patients in the intervention group also experienced a significantly shorter mean ventilator weaning time (P < 0.001) and intensive care unit stay duration (P < 0.001). The overall distribution of postoperative morbidities did not differ significantly between the groups (P = 0.059).

Conclusion: Adding dexmedetomidine to modified Del Nido cardioplegia significantly improved myocardial protection in children undergoing corrective CHD surgery.

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Cite

BibTeXRIS
BibTeX
@article{samadieh2026effect,
  title = {{The Effect of Adding Dexmedetomidine to Modified Del Nido Cardioplegia Solution on Myocardial Protection in Children Undergoing Congenital Heart Defect Surgery - A Prospective, Randomized, Triple-Blind, Controlled Trial}},
  author = {Farhad Samadieh and Mahmood Hosseinzadeh Maleki and Masoud Razeghian and Tahereh Izanlou and Mohammadreza Naghibi Sistani and Benyamin Fazli and Mohsen Yaghubi},
  journal = {Brazilian Journal of Cardiovascular Surgery},
  year = {2026},
  month = sep,
  doi = {10.21470/1678-9741-2025-0415},
  url = {https://doi.org/10.21470/1678-9741-2025-0415},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The Effect of Adding Dexmedetomidine to Modified Del Nido Cardioplegia Solution on Myocardial Protection in Children Undergoing Congenital Heart Defect Surgery - A Prospective, Randomized, Triple-Blind, Controlled Trial
AU  - Farhad Samadieh
AU  - Mahmood Hosseinzadeh Maleki
AU  - Masoud Razeghian
AU  - Tahereh Izanlou
AU  - Mohammadreza Naghibi Sistani
AU  - Benyamin Fazli
AU  - Mohsen Yaghubi
PY  - 2026
DA  - 2026/09/08
JO  - Brazilian Journal of Cardiovascular Surgery
DO  - 10.21470/1678-9741-2025-0415
UR  - https://doi.org/10.21470/1678-9741-2025-0415
AB  - Introduction: The myocardial ischemia-reperfusion injury (IRI) is an indispensable factor in pediatric congenital heart defect (CHD) surgery. Although effective myocardial protection strategies are crucial, the issue remains a dilemma. This study aimed to evaluate the effect of adding dexmedetomidine to modified Del Nido cardioplegia on myocardial protection in children undergoing CHD surgery.  Methods: This was a prospective, randomized, triple-blind, controlled clinical trial. A total of 60 pediatric patients were enrolled and randomized 1:1 into two groups - an intervention group that received dexmedetomidine-enriched modified Del Nido cardioplegia and a control group that received standard modified Del Nido cardioplegia with normal saline. Primary outcomes included serum troponin I and creatine kinase-MB levels, as well as coronary sinus lactate levels. Secondary outcomes were the vasoactive-inotropic score, weaning time from mechanical ventilation, and intensive care unit length of stay.  Results: Adding dexmedetomidine to modified Del Nido cardioplegia significantly improved myocardial protection in children undergoing CHD surgery. The intervention group showed significantly lower troponin I levels at all postoperative time points compared to the control group (P < 0.001). Similarly, the dexmedetomidine group had significantly lower vasoactive-inotropic score at all time points (P < 0.001). Patients in the intervention group also experienced a significantly shorter mean ventilator weaning time (P < 0.001) and intensive care unit stay duration (P < 0.001). The overall distribution of postoperative morbidities did not differ significantly between the groups (P = 0.059).  Conclusion: Adding dexmedetomidine to modified Del Nido cardioplegia significantly improved myocardial protection in children undergoing corrective CHD surgery.
SN  - 0102-7638
SN  - 1678-9741
ER  -