Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate - a retrospective study

Lindner, Gregor; Zapletal, Bernhard; Schwarz, Christoph; Wisser, Wilfried; Hiesmayr, Michael; Lassnigg, Andrea (2012). Acute hyponatremia after cardioplegia by histidine-tryptophane-ketoglutarate - a retrospective study. Journal of cardiothoracic surgery, 7, p. 52. London: Biomed Central 10.1186/1749-8090-7-52

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Background Hyponatremia is the most common electrolyte disorder in hospitalized patients and is known to be associated with increased mortality. The administration of antegrade single-shot, up to two liters, histidine-tryptophane-ketoglutarate (HTK) solution for adequate electromechanical cardiac arrest and myocardial preservation during minimally invasive aortic valve replacement (MIAVR) is a standard procedure. We aimed to determine the impact of HTK infusion on electrolyte and acid–base balance. Methods In this retrospective analysis we reviewed data on patient characteristics, type of surgery, arterial blood gas analysis during surgery and intra-/postoperative laboratory results of patients receiving surgery for MIAVR at a large tertiary care university hospital. Results A total of 25 patients were included in the study. All patients were normonatremic at start of surgery. All patients developed hyponatremia after administration of HTK solution with a significant drop of serum sodium of 15 mmol/L (p < 0.01). Measured osmolality did not change during all times of surgery compared to start of surgery (p = 0.28 – p = 0.79), indicating isotonic hyponatremia. After administration of HTK solution pH fell significantly due to development of metabolic acidosis. Conclusions Acute hyponatremia during cardioplegia with HTK solution is isotonic and should probably not be corrected without presence of hypotonicity as confirmed by measurement of serum osmolality.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Lindner, Gregor




Biomed Central




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Date Deposited:

04 Oct 2013 14:39

Last Modified:

28 Dec 2014 06:35

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URI: (FactScience: 223104)

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