St Thomas’ Hospital Cardioplegic 1000 ml Solution
PDF Leaflet Revision Date: 28 March 2018
Clinical Summary
Quick overview from the medicine insert
Indication
Use as a cardioplegic solution.
Dosage (summary)
Induction: 10-20 ml/kg; Multidose: 5-10 ml/kg every 20-30 mins.
Special Populations
- Congestive heart failure
- Severe renal insufficiency
- Hyperkalemia
Pregnancy & Breastfeeding
Safety in pregnancy has not been established.
Key Drug Interactions
- Amioderone therapy
Contraindications
- Patients on Amioderone therapy
Common side effects
- Febrile response
- Extravasation
- Hypervolemia
Counselling Points
- Mix with sodium bicarbonate before use
- Infuse under positive pressure
- Use aseptic technique for additives
Serious warnings
- Use with caution in patients with sodium or potassium retention
- Fluid overload risk
- Do not mix with calcium chelators
Important Disclaimer
The St Thomas’ Hospital Cardioplegic 1000 ml Solution professional information leaflet below is the property of Adcock Ingram Critical Care and is provided on Medinsert exactly as issued, with no.. alterations or editorial changes. We make every effort to keep content current by updating documents as soon as new versions become available. Medinsert serves as a trusted access point for healthcare professionals, but does not replace official sources or clinical judgement. For more details, please read our full disclaimer. read more>>
Healthcare Professionals Only
This content is for registered healthcare professionals
Sign in or create a free account to read the full package insert.
Free for HPCSA-registered professionals. Powered by Medinsert.
Clinical Particulars
Section 4 of the official insert — extracted exactly as issued, no alterations
4.1 Therapeutic indications
Use as a cardioplegic solution.
4.3 Contraindications
It is recommended that cardioplegia is not administered to patients currently on Amioderone therapy. Amioderone should be discontinued for a minimum of six weeks prior to cardiac surgery.
4.4 Special warnings and precautions for use
1. Solutions containing sodium should be used with great care in patients with congestive heart failure, severe renal insufficiency, and in clinical states in which there exists oedema with or without sodium retention.
2. Solutions containing potassium ions should be used with great care in patients with hyperkalemia, severe renal failure and in conditions in which potassium retention is present.
3. Solutions containing calcium ions should not be administered through the same administration set as blood anticoagulated with calcium chelators, e.g. Anticoagulants, Citrate, Glucose or Citrate Phosphate Glucose, because of the likelihood of coagulation.
4. The intravenous administration of these solutions can cause fluid and/or solute overloading, resulting in dilution of serum concentrations, overhydration, congested states and/or pulmonary oedema.
5. Additives may be incompatible. Consult with pharmacist, if necessary, to ensure compatibility of prescribed additives. When introducing additives, use aseptic technique. Mix thoroughly when additives have been introduced.
6. Do not store solutions containing additives for more than 24 hours. Do not administer unless the solution is clear and the container is intact.
4.2 Posology and method of administration
Before use mix with 10 ml of 8,5% sodium bicarbonate and if required 3,6 ml of 50% glucose injection. An induction dose of 10 - 20 ml/kg of ST THOMAS' HOSPITAL CARDIOPLEGIC SOLUTION II should be infused into the coronary circulation immediately after aortic clamping in order to effect rapid electro-mechanical arrest. Thereafter multidose cardioplegia 5 - 10 ml/kg, is reinfused every 20 - 30 minutes throughout the ischaemia cross clamp period. The solution is infused under positive pressure, and it is recommended that the infusion pressure (measured at the aortic root) should not exceed 100 mmHg. The solution should be infused at a temperature of 4 u00b0C to 10 u00b0C. It is recommended that an in-line cardioplegic filter of at least 0,8 micron is used.
4.8 Undesirable effects
Reactions which may occur because of the solution or the technique of administration include febrile response, extravasation and hypervolemia.
4.6 Fertility, pregnancy and lactation
Safety in pregnancy has not been established.
