EVALUATION OF HYPERKALEMIA AFTER DELNIDO CARDIOPLEGIA ADMINISTRATION IN UNDERGOING CABG SURGERY

Abstract

Background: Coronary artery bypass grafting (CABG) requires effective myocardial protection, commonly achieved using cardioplegia solutions. Del Nido cardioplegia has gained popularity in adult cardiac surgery; however, its high potassium content may predispose patients to perioperative hyperkalemia, a potentially serious electrolyte disturbance.Objective: To evaluate the incidence and predictors of hyperkalemia following Del Nido cardioplegia administration in patients undergoing elective CABG surgery. Methods: This observational cross-sectional study was conducted over four months in a tertiary care hospital and included 196 patients undergoing elective on-pump CABG surgery. Serum potassium levels were measured preoperatively, intraoperatively, and 15 minutes after cardioplegia administration. Hyperkalemia was defined as serum potassium >5.0 mmol/L. Data on demographic, clinical, and intraoperative variables were analyzed using SPSS version 27. Paired t-test, Chi-square test, and correlation analysis were applied, with p ≤ 0.05 considered statistically significant. Results: The mean age of patients was 60.64 ± 4.54 years, with a predominance of males (60.2%). The incidence of hyperkalemia after Del Nido cardioplegia was 50.5%. Serum potassium levels increased significantly from 4.49 ± 0.27 mmol/L to 5.53 ± 0.57 mmol/L (p < 0.001). Hyperkalemia was significantly associated with older age, higher BMI, diabetes mellitus, hypertension, smoking, male gender, increased cardioplegia volume, prolonged aortic cross-clamp time, and longer cardiopulmonary bypass (CPB) duration (all p < 0.001). Strong positive correlations were observed between post-cardioplegia potassium levels and intraoperative potassium, cardioplegia volume, cross-clamp time, and CPB duration (r > 0.92). Conclusion: Hyperkalemia is a common and clinically significant complication following Del Nido cardioplegia in adult CABG patients. Its occurrence is strongly associated with patient comorbidities and intraoperative factors. These findings highlight the need for strict perioperative potassium monitoring and risk-based management strategies to improve surgical safety and outcomes.