Trial reportThe Journal of thoracic and cardiovascular surgery2018
The use of del Nido cardioplegia in adult cardiac surgery: A prospective randomized trial.
Trial report in The Journal of thoracic and cardiovascular surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 58 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Lactated Ringer's Solution and PlasmaLyte-A as a Base Solution for Del Nido Cardioplegia
Clinical Outcomes of Del Nido Cardioplegia in Adult Cardiac Surgery: a Randomized Controlled Trial
Investigation of Myocardial Protection Level by Oxidative Stress and Endothelial Damage With Two Cardioplegia Methods Used During Cardiac Surgery
Evaluation of the Effective Myocardial Protection Duration of Del Nido Cardioplegia: A Prospective Observational Study in Adult Patients Undergoing Cardiac Surgery
Who cites it
58 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.British journal of anaesthesia · 2025Guideline
- Del Nido cardioplegia versus cold blood cardioplegia in adult cardiac surgery: a meta-analysis of randomized clinical trials.Journal of cardiothoracic surgery · 2024Pooled it
- Buckberg versus Del Nido in isolated aortic valve replacement: a prospective, two-centre, randomized trial.Interdisciplinary cardiovascular and thoracic surgery · 2025Trial
- Comparison of routine del Nido cardioplegia vs two types of modified del Nido cardioplegias for myocardial protection among patients undergoing coronary artery bypass grafting (CABG) surgeries: A randomized double-blind clinical trial.The journal of extra-corporeal technology · 2024Trial
- Protective Efficacy on Adult Ischemic Myocardium under Bypass: Del Nido vs. St. Thomas Blood Cardioplegia.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2023Trial
- Cardioplegia strategy and perioperative blood transfusion in isolated coronary artery bypass surgery: a propensity-weighted analysis.Journal of cardiothoracic surgery · 2026Article
- Myocardial protection during cardiac surgery: Scientific principles and practical recommendations.JTCVS structural and endovascular · 2026Article
- Vasculoprotective role of del Nido cardioplegia in open-heart surgery via modulation of E-Selectin, Endocan, and TNF-alpha coronary sinus blood samples.Journal of cardiothoracic surgery · 2025Article
- Saline-based modified del Nido cardioplegia versus multidose St. Thomas cardioplegia in canine mitral valve repair: A randomized controlled trial.Veterinary surgery : VS · 2025Article
- Evaluation of Myocardial Protection in Prolonged Aortic Cross-Clamp Times: Del Nido and HTK Cardioplegia in Adult Cardiac Surgery.Medicina (Kaunas, Lithuania) · 2025Article
- Efficacy of Single-Dose Del Nido Cardioplegia Beyond 90 Minutes in Adult Cardiac Surgery.Journal of clinical medicine · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- 2024 EACTS/EACTAIC/EBCP Guidelines on cardiopulmonary bypass in adult cardiac surgery.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Comparison of the effect of cardioplegic solutions used in cardiac surgery on myocardial protection.Revista da Associacao Medica Brasileira (1992) · 2025Article
- Single-dose modified bloodless del Nido cardioplegia for minimally invasive cardiac surgery.Frontiers in cardiovascular medicine · 2025Article
- Outcomes of Del Nido and hyperkalemic blood cardioplegia in adult cardiac surgery with prolonged aortic cross-clamp times★.The journal of extra-corporeal technology · 2024Article
- Comparison of St. Thomas II Cardioplegia and Modified Del Nido Cardioplegia in Dogs Undergoing Mitral Valve Surgery.Veterinary sciences · 2024Article
- Del nido cardioplegia in adults: a retrospective observational study in comparison to modified St. Thomas cardioplegia in cardiac surgery.Journal of cardiothoracic surgery · 2024Observational
- Comparison of Del Nido (a different application) and crystalloid blood cardioplegia on arrhythmia and early results.Journal of cardiothoracic surgery · 2024Article
- Myocardial protection: comparing histological effects of single-dose cardioplegic solutions-study protocol for a secondary analysis of the CARDIOPLEGIA trial.Journal of thoracic disease · 2024Article
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Authors and funding
6 authors.
Funding
Abstract
objectivesThe del Nido cardioplegia solution has been used extensively in congenital heart surgery for more than 20 years and more recently for adults. This randomized controlled trial examined whether expanding this technique to adult cardiac surgery confers benefits in surgical workflow and clinical outcome compared with blood-based cardioplegia.
methodsAdult first-time coronary artery bypass grafting (CABG), valve, or CABG/valve surgery patients requiring cardiopulmonary bypass (CPB) were randomized to del Nido cardioplegia (n = 48) or whole blood cardioplegia (n = 41). Primary outcomes assessed myocardial preservation. Troponin I was measured at baseline, 2 hours after CPB termination, 12 and 24 hours after cardiovascular intensive care unit admission. Alpha was set at P < .001.
resultsPreoperative characteristics were similar between groups, including age, Society of Thoracic Surgeons risk score, CABG, and valve procedures. There was no significant difference on CPB time (97 vs 103 minutes; P = .288) or crossclamp time (70 vs 83 minutes; P = .018). The del Nido group showed higher return to spontaneous rhythm (97.7% vs 81.6%; P = .023) and fewer patients required inotropic support (65.1% vs 84.2%; P = .050), but did not reach statistical significance. Incidence of Society of Thoracic Surgeons-defined morbidity was low, with no strokes, myocardial infarctions, renal failure, or operative deaths. For del Nido group patients, troponin levels did not increase as much as for control patients (P = .040), but statistical significance was not reached.
conclusionsEvidence from this study suggests del Nido cardioplegia use in routine adult cases may be safe, result in comparable clinical outcomes, and streamline surgical workflow. The trend for troponin should be investigated further because it may suggest superior myocardial protection with the del Nido solution.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.