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I think it's important to take some time out of our day to stop, breathe, reflect, appreciate and be proud of all we've achieved - no matter how big or small.Department of Dermatology, Vienna General Hospital, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria Received 19 June 2014; Revised 31 July 2014; Accepted 11 August 2014; Published 8 September 2014Academic Editor: M.-Saadeh Suleiman Copyright © 2014 Andreas Habertheuer et al.For the majority of cardiac surgical interventions arresting the heart is inevitable, with systemic arterial perfusion and oxygenation being transferred to a heart lung machine.Until the present day, cardioplegic arrest remains the gold standard of cardioprotection and requires a potassium rich solution sending the heart into a depolarized arrest [1].Many, in part adversarial, regimens to protect the myocardium from ischemic insults have entered clinical routine; however, functional recovery of the heart is still often impaired due to perfusion injury.

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In general, the elderly represent a comorbidly ill patient population with a higher perioperative risk.Even in patients with higher operative risk (female sex, age 5), no statistically significant differences could be demonstrated [11, 12]. [13] from the Toronto University compared 34 trials with a total of 5,044 patients.2,582 received blood cardioplegia and 2,462 received crystalloid cardioplegia (no differentiation between intracellular and extracellular type crystalloid solutions was made).Upon stimulation by the sinuatrial node, voltage dependent Na channels remain inactivated.As this state does not allow any repolarisation either the current clinical practice of hyperkalemic cardiolegia induction is called depolarized arrest.Blood cardioplegia is mixed in a ratio of 1 : 4 (1 part of crystalloid solution and 4 parts of blood); crystalloid solutions may be of intracellular type (Custadiol) or extracellular type (Plegisol). Modes of application range from antegrade versus retrograde versus antegrade plus retrograde, intermittent versus single shot, cold (with or without additional warm induction) versus warm.

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