ringer acetate based del Nido cardioplegia

Ringer acetate based Del Nido cardioplegia is a modified formulation of the original Del Nido cardioplegic solution used for myocardial protection during cardiac surgery. Unlike the standard Del Nido solution, which uses Plasma-Lyte A as its base, this variant utilizes Ringer's acetate (or plain Ringer's) as the crystalloid base. The typical composition per 800 mL of base includes sodium (147 mEq/L), chloride (155 mEq/L), potassium (4 mEq/L), calcium (4 mEq/L), and a pH around 7.4. To this are added mannitol 20% (16.3 mL), magnesium sulfate 50% (4 mL), sodium bicarbonate 8.4% (13 mL), potassium chloride 2 mEq/mL (13 mL), and lidocaine 1% (13 mL). The final mixture is often combined with oxygenated patient blood in a ratio of four parts crystalloid to one part blood. The mechanism of action involves inducing diastolic cardiac arrest primarily through high potassium-induced depolarization, membrane stabilization via lidocaine-mediated sodium channel blockade, reduction of free radical injury by mannitol, calcium channel blockade by magnesium sulfate, and buffering acidosis with sodium bicarbonate[2][3][4]. This formulation provides prolonged myocardial protection during surgery—typically up to 90 minutes after a single dose—by minimizing metabolic demand and protecting against ischemia-reperfusion injury[2].

Other names

ringer-based del Nido cardioplegiaRinger's acetate-based del Nido solutionprdNCS