modified del Nido cardioplegia

Modified del Nido cardioplegia is a single-dose, hyperkalemic, intracellular-like cardioplegic solution used for myocardial protection during cardiac surgery. The solution is a variation of the original del Nido formula, which typically uses Plasma-Lyte A as its crystalloid base. The "modified" version substitutes Plasma-Lyte A with more readily available crystalloids such as Lactated Ringer's solution, Ringer's acetate, or normal saline. The final formulation is usually a mixture of this crystalloid base with blood (commonly in a 4:1 or 8:2 ratio). It contains potassium chloride to induce rapid diastolic arrest via membrane depolarization, lidocaine to block sodium channels and prevent calcium overload, magnesium sulfate as a calcium antagonist and membrane stabilizer, sodium bicarbonate to buffer metabolic acidosis, and mannitol to provide osmotic support and scavenge free radicals. This combination allows for a single-dose administration that provides approximately 60 to 90 minutes of myocardial protection, facilitating complex or uninterrupted surgical procedures.

Other names

mDNCmDNmodified DN cardioplegiaLactated Ringer-based del Nido cardioplegiaRinger acetate-based modified del Nido cardioplegiasaline-based modified del Nido cardioplegiaLR DN