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The concept of national indifference calls into question the power of nationalism as a motive for action and the mass appeal of nationalism. CKMB release after surgery at 24 hours was reduced with blood cardioplegia (5.9 U/L 95% CI, 1.6 to 10.2 P=0.007 821 patients, 7 trials).īlood cardioplegia provides superior myocardial protection as compared with crystalloid cardioplegia, including lower rates of LOS, and early CKMB increase, whereas the incidence of myocardial infarction and death are similar.The vast body of inquiry into nationalism has traditionally seen Europe as a main center for the emergence of nationalism, but scholars of “national indifference” have countered with the idea that nationalism may not matter much at all as a motive for most people. The incidence of MI and death were similar between treatment groups (MI: OR, 0.78 95% CI, 0.54 to 1.13 4316 patients, 23 trials) (death: OR, 0.80 95% CI, 0.46 to 1.40 4022 patients, 17 trials).

The incidence of LOS was decreased significantly with blood cardioplegia (OR, 0.54 95% confidence interval, 0.34 to 0.84 P=0.006 879 patients, 10 trials).

The majority of trials were conducted in patients undergoing elective CABG surgery (n=18). Random effects summary odds ratio (OR) for binary outcomes, and weighted mean difference for continuous outcomes were calculated. Surrogate outcomes included postoperative creatinine kinase MB (CKMB) increase. The primary outcomes were: low output syndrome (LOS), myocardial infarction (MI), and death. Each trial was blindly assessed and abstracted by 2 reviewers. The search was restricted to peer-reviewed English language publications of randomized controlled trials that primarily compared blood and crystalloid cardioplegia in adult patients. MEDLINE, EMBASE, and the Cochrane registry of controlled trials were searched for clinical trials. This meta-analysis describes the effectiveness of blood cardioplegia in lowering adverse postoperative outcomes. Blood cardioplegia provides a closer approximation to normal physiology, which may translate into measurable clinical benefits. Many small, randomized, controlled trials have evaluated the effectiveness of blood as compared with crystalloid cardioplegia for myocardial protection during cardiac surgery.