Where could I read more about this? I find it interesting.
From: PerfList Discussion Forum <[login to unmask email]>
Sent: Sunday, August 25, 2019 3:07:04 AM
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Subject: [EXTERNAL] [PerfList Discussion Forum] - List Digest, Aug 24, 2019
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The following posts were made on Aug 24, 2019
1. RE: 4:1 "Del Nido" - (Thomas N Muziani, PA-C, CP)
1. RE: 4:1 "Del Nido" (Thomas N Muziani, PA-C, CP<mailto:[login to unmask email]>)
From: Thomas N Muziani, PA-C, CP
Subject: RE: 4:1 "Del Nido"
Although this issue has been discussed before ( using del Nido in variations other than what has been published) "modifying" the solution seems to have gained traction over the last year.
The bottom regarding customizing any cardioplegia is this;
Modifying the solution in configurations other than what Dr. del Nido has published, exposes you, your institution and your surgeon to a whole world of hurt:
1. It can no longer be considered a "del Nido cardioplegia" and your safest and most obvious avenue is to drop the "del Nido" moniker immediately.
2. The days of customizing your cardioplegia without voluminous research, animal testing and documentation are over. A court of law will demand hard documentation and without that you are fully exposed.
3. Due to a small compounding company, New England Compounding Pharmacy, producing a contaminated spinal solution causing several deaths, a Federal law has mandated that ALL compounded solutions have to undergo testing for Stability, Sterility and Endotoxins. This may very well be the first reason your Pharmacy has refused to compound the solution for you.
4. I could go on, but I will end it with this; If you ever experience an unintended consequence and your patient suffers, do not rely on your surgeon or institution to take the bullet if it's "custom" cardioplegia. And, it would be wise to check with your insurance provider to see if they cover you acting as a Pharmacist.
Please know I am certainly on your side for utilizing the benefits of Lidocaine, magnesium and a low potassium formula in a 4:1 format. It is a wonderful cocktail. But the days of you customizing a solution without proper documentation and empirical data are effectively over.
Warm regards, T. N. Muziani
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