Bretschneider's Histidine-Tryptophan-Ketoglutarate (HTK, Custodiol^®) solution has an ionic composition closely resembling intracellular fluid with a sodium concentration of 15 mM. Unlike the high potassium content of other cardioplegia concepts, the low potassium concentration (10 mM K+) has been proven to be less deleterious. By the addition of buffer substances such as histidine in Bretschneider's solution, any lowering of pH due to tissue ischemia can be neutralized. By the addition of oxygen scavengers, such as histidine or mannitol, free oxygen radicals can be captured or reduced in numbers. The mode of action of HTK solution depends on a so-called 'equilibration' of the extracellular compartment. By perfusion with a low-viscosity fluid the temperature and composition of the interstitial fluid are rendered practically identical with those of the preservative solution. Complete equilibration takes time, because the separate constituents of the extracellular fluid shift at different speeds as they come into line with the composition of the preservative solution. Calcium equilibration needs more time than sodium equilibration. This difference in kinetics can be evened out, for example, by adding magnesium, a calcium antagonist. Still, equilibration of sodium and potassium are diffusion driven processes which require a certain time. In conclusion, both the composition and the method of application of Bretschneider’s cardioplegia enable a safe protection of the heart. 

This webinar reviews the most important standpoints in terms of theoretical and practical analyses in the use of Bretschneider’s cardioplegia.  

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This event is targeted at physicians, pharmacists and healthcare professionals and is free of charge. Register to receive the link to the live webinar using the form below.

Moderation: Dr. Stefan Fritz (Köhler Campus)

The content of this event is designed to be product and service neutral. We confirm that the scientific management and the speakers disclose potential conflicts of interest to the participants. There is no sponsorship of the event, the total expenses of the event are about 750 €.

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