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The spectrum of opinion regarding the safety, simplicity,\udclinical application and reversibility of cardioplegia\udvaries from total scepticism and discouragement of\udits use to advocacy of constant employment with remarkable\udsuccess. Similar disagreement exists as to which of the cardioplegic agent is the best.\ud—Kaplan and Fisher1 (1959) p. 833\ud\udKaplan and Fisher wrote these edifying words more than\ud50 years ago, after which there was a 15-year surgeoninstigated moratorium on potassium cardioplegia. Today, more than 2 metric tons of depolarizing potassium are\udpassed through the coronary arteries of 350,000 patients undergoing elective coronary artery bypass graft (CABG) and\udvalvular operations each year in the United States and more\udthan 4 metric tons in more than 800,000 patients in the 2500\udcardiac centers worldwide. Despite surgical proficiency and\udmedical innovation driving low in-hospital mortality rates of 1% to 3% for CABG surgery and approximately 6% for\udvalvular surgery, there remains an ongoing challenge to reduce postoperative complications, particularly in older patients with multiple comorbidities and in emergency and\udredo procedures. Currently, about 10% of patients will\udhave postoperative low cardiac output syndrome, 25% to\ud40% of CABG patients will have postoperative atrial\udfibrillation, 4% to 40% may have some form of renal\uddysfunction, 10%to 40%may have transient cognitive dysfunction and delirium, and of the total number of patients undergoing cardiac surgery at tertiary referral centers 4% to 11% may require prolonged intensive care, which carry significantly higher mortality rates.3,4\udThe etiology of postoperative complications in adult cardiac\udsurgery or pediatric congenital corrective operations is\udmultifactorial and includes age, gender and ethnicity, cardiopulmonary bypass time, technical difficulty and urgency of the operation, temperature transitions, low preoperative left ventricular ejection fraction, and pre-existing medical conditions such as diabetes, obesity, renal disease, hypertension, and metabolic disorders

Membrane polarity: A target for myocardial protection and reduced inflammation in adult and pediatric cardiothoracic surgery