EVENT ABSTRACTS
Background: In the US, del Nido cardioplegia, developed for the immature myocardium, is widely used in paediatric cardiac surgery. Del Nido has not been commercially available in the UK and St Thomas’ blood cardioplegia, developed for the adult myocardium, remains standard. The DESTINY trial, a multicentre randomised controlled trial, compared del Nido and St Thomas’ to determine whether one solution is associated with less myocardial injury. The setup, dose and composition of del Nido is different to St Thomas’ and the experiences of Surgeons and Perfusionists within DESTINY were explored in this qualitative sub-study, as many participants were using del Nido for the first time.
Aim: To explore the experiences of surgeons and perfusionists using del Nido during the DESTINY trial, to support its potential UK implementation and identify practical or safety concerns.
Hypothesis: Del Nido offers practical benefits compared to St Thomas’, as perceived by both surgeons and perfusionists in paediatric cardiac surgery.
Design: A qualitative study using semi-structured interviews with surgeons and perfusionists who had completed 3 or more del Nido cases within the DESTINY trial centres. Interviews were conducted, digitally recorded, transcribed and thematically analysed.
Results: Twelve participants were interviewed- six surgeons and six perfusionists from four trial centres: Birmingham Children’s Hospital; Bristol Royal Infirmary Children’s Hospital; Great Ormond Street Hospital for Children and Leeds Children’s Hospital. Four key themes emerged from interviews:
Conclusions: Both surgeons and perfusionists find that del Nido has practical benefits over St Thomas’, but further research on the optimal cooling temperature, blood to crystalloid ratio and dosing for paediatric use are required to support the development of a best practice guideline and guide protocol alteration.
Kirsty started her career has a paediatric intensive care nurse where she was exposed to ECMO and the perfusion department at Birmingham Children's Hospital. From there her interests grew, until she obtained her trainee position, now waiting to sit her final exam.
