Composition of common potassium-based cardioplegic solutions.
\\n\\n
More than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\\n\\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\\n\\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\\n\\nAdditionally, each book published by IntechOpen contains original content and research findings.
\\n\\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\\n\\n\\n\\n
\\n"}]',published:!0,mainMedia:{caption:"IntechOpen Maintains",originalUrl:"/media/original/113"}},components:[{type:"htmlEditorComponent",content:'
Simba Information has released its Open Access Book Publishing 2020 - 2024 report and has again identified IntechOpen as the world’s largest Open Access book publisher by title count.
\n\nSimba Information is a leading provider for market intelligence and forecasts in the media and publishing industry. The report, published every year, provides an overview and financial outlook for the global professional e-book publishing market.
\n\nIntechOpen, De Gruyter, and Frontiers are the largest OA book publishers by title count, with IntechOpen coming in at first place with 5,101 OA books published, a good 1,782 titles ahead of the nearest competitor.
\n\nSince the first Open Access Book Publishing report published in 2016, IntechOpen has held the top stop each year.
\n\n\n\nMore than half of the publishers listed alongside IntechOpen (18 out of 30) are Social Science and Humanities publishers. IntechOpen is an exception to this as a leader in not only Open Access content but Open Access content across all scientific disciplines, including Physical Sciences, Engineering and Technology, Health Sciences, Life Science, and Social Sciences and Humanities.
\n\nOur breakdown of titles published demonstrates this with 47% PET, 31% HS, 18% LS, and 4% SSH books published.
\n\n“Even though ItechOpen has shown the potential of sci-tech books using an OA approach,” other publishers “have shown little interest in OA books.”
\n\nAdditionally, each book published by IntechOpen contains original content and research findings.
\n\nWe are honored to be among such prestigious publishers and we hope to continue to spearhead that growth in our quest to promote Open Access as a true pioneer in OA book publishing.
\n\n\n\n
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"4645",leadTitle:null,fullTitle:"Biodegradation and Bioremediation of Polluted Systems - New Advances and Technologies",title:"Biodegradation and Bioremediation of Polluted Systems",subtitle:"New Advances and Technologies",reviewType:"peer-reviewed",abstract:"This book contains a collection of research works focused on the biodegradation of different types of pollutants, both in water and solids. The book is divided in three major sections: A) Biodegradation of organic pollutants in solids and wastewater, B) Biodegradation of complex pollutants, and C) Novel technologies in biodegradation and bioremediation.",isbn:null,printIsbn:"978-953-51-2238-8",pdfIsbn:"978-953-51-5418-1",doi:"10.5772/59459",price:119,priceEur:129,priceUsd:155,slug:"biodegradation-and-bioremediation-of-polluted-systems-new-advances-and-technologies",numberOfPages:178,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:"de86e2d98b4cc7ee51ca11a65f08079f",bookSignature:"Rolando Chamy, Francisca Rosenkranz and Lorena Soler",publishedDate:"December 17th 2015",coverURL:"https://cdn.intechopen.com/books/images_new/4645.jpg",numberOfDownloads:19038,numberOfWosCitations:38,numberOfCrossrefCitations:24,numberOfCrossrefCitationsByBook:2,numberOfDimensionsCitations:54,numberOfDimensionsCitationsByBook:2,hasAltmetrics:0,numberOfTotalCitations:116,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 15th 2014",dateEndSecondStepPublish:"November 5th 2014",dateEndThirdStepPublish:"February 9th 2015",dateEndFourthStepPublish:"May 10th 2015",dateEndFifthStepPublish:"June 9th 2015",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"165784",title:"Dr.",name:"Rolando",middleName:null,surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy",profilePictureURL:"https://mts.intechopen.com/storage/users/165784/images/4439_n.jpg",biography:"Rolando Chamy obtained his professional degree in Biochemical Engineering from Pontificia Universidad Catolica de Valparaíso (PUCV), Chile, in 1982. He obtained his PhD in Chemical Engineering from the University of Santiago de Compostela, Spain, in 1991. The same year, he became fulltime Professor in the School of Biochemical Engineering at PUCV. He also participated in the creation of the Biotechnology Center (NBC) of PUCV. Currently, Dr. Chamy serves as the Director of NBC and is the main researcher of the bioenergy unit of Fraunhofer Chile Research. His research interests are in the fields of bioenergy, biofuels, environmental engineering, and climate change. Dr. Chamy has authored and coauthored more than 200 scientific publications.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"4",institution:{name:"Pontificial Catholic University of Valparaiso",institutionURL:null,country:{name:"Chile"}}}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,coeditorOne:{id:"252346",title:"Dr.",name:"Francisca",middleName:null,surname:"Rosenkranz",slug:"francisca-rosenkranz",fullName:"Francisca Rosenkranz",profilePictureURL:"https://mts.intechopen.com/storage/users/252346/images/system/252346.jpg",biography:"Francisca Rosenkranz, candidate for PhD in Biotechnology for the program that this house of studies teaches with the Santa María University. Francisca Rosenkranz, who is doing her doctoral thesis in co-tutelage with the University of Santiago de Compostela, Spain.",institutionString:null,position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"0",totalChapterViews:"0",totalEditedBooks:"0",institution:null},coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"863",title:"Biodegradation",slug:"biodegradation"}],chapters:[{id:"49070",title:"Fungi in Landfill Leachate Treatment Process",doi:"10.5772/60863",slug:"fungi-in-landfill-leachate-treatment-process",totalDownloads:2109,totalCrossrefCites:4,totalDimensionsCites:10,hasAltmetrics:0,abstract:"The landfill leachate has high concentration of COD, ammonia and other recalcitrant composition compounds. The amount of eachwhich is mainly largely dependent on the age of the landfill. The conventional leachate treatments can be classified as chemical-physical treatments and biological treatments. Using fungi to treat leachate is an emerging research topic. Fungi, with their excellent recalcitrant compound degradability, have been used to treat industrial wastewater that contains toxic or recalcitrant compound. Due to the complex composition and toxicity of landfill leachate, fungi have showed shown better removal efficiency in terms of COD, toxicity and color removal than the conventional leachate treatment. White rot fungi species and yeast are so far the two species that have been studied in treating landfill leachate. Future research should be extended to the other fungi species as well asand also on the impact of ammonia in landfill leachate on the fungi treatment process.",signatures:"Yanan Ren and Qiuyan Yuan",downloadPdfUrl:"/chapter/pdf-download/49070",previewPdfUrl:"/chapter/pdf-preview/49070",authors:[{id:"173704",title:"Dr.",name:"Qiuyan",surname:"Yuan",slug:"qiuyan-yuan",fullName:"Qiuyan Yuan"}],corrections:null},{id:"49735",title:"Culture Condition Effect on Bioflocculant Production and Actual Wastewater Treatment Application by Different Types of Bioflocculants",doi:"10.5772/62114",slug:"culture-condition-effect-on-bioflocculant-production-and-actual-wastewater-treatment-application-by-",totalDownloads:1935,totalCrossrefCites:2,totalDimensionsCites:5,hasAltmetrics:0,abstract:"The effect of culture condition on different types of bioflocculant production and its application on actual wastewater treatment were studied in this chapter. The advantages of mixed strain HXJ-1 were as follows: directly using acidic wine wastewater, adapting to wastewater at high concentrations and the presence of less nitrogen. HXJ-1 achieved good flocculating rate when the chemical oxygen demand (COD) was 12,000 mg/L, C/N 20:1. Three kinds of bioflocculants had some good treatment results on starch wastewater, printing and dyeing wastewater and landfill leachate. The treatment effect of XJBF-1 (produced by mixed strain HXJ-1) on the starch wastewater was better than that of traditional polyacrylamide and other bioflocculants produced by a single bacterial (X15BF-1) and yeast strain (J1BF-1). XJBF-1 had better treatment results on three types of wastewater. It also had good removal rate of chromaticity, especially on the starch wastewater , the printing and dyeing wastewater; the removal rate was up to 88%, and the starch wastewater COD removal rate was up to 86%.",signatures:"Fan Zhang, Wenju Jiang, Xiangdong Wang, Xiujuan Ji, Yina Wang,\nWang Zhang and Jiao Chen",downloadPdfUrl:"/chapter/pdf-download/49735",previewPdfUrl:"/chapter/pdf-preview/49735",authors:[{id:"174018",title:"Ph.D.",name:"Fan",surname:"Zhang",slug:"fan-zhang",fullName:"Fan Zhang"}],corrections:null},{id:"48997",title:"Anaerobic Biodegradation of Solid Substrates from Agroindustrial Activities — Slaughterhouse Wastes and Agrowastes",doi:"10.5772/60907",slug:"anaerobic-biodegradation-of-solid-substrates-from-agroindustrial-activities-slaughterhouse-wastes-an",totalDownloads:2175,totalCrossrefCites:6,totalDimensionsCites:9,hasAltmetrics:0,abstract:"Solid wastes from the meat industry are produced in large amounts resulting in a negative impact on the environment if not properly treated. Due to their high content of proteins and fats, these residues are excellent substrates for anaerobic digestion which holds high potential for methane yield. However, possible toxic compounds may be formed during its biodegradation with a consequent failure of the process under long-term operation. The anaerobic co-digestion of such residues with other co-substrates as those generated in agricultural activities has been proposed as a good alternative to overcome these problems. Nevertheless, today there is very little knowledge to assess on mixture interactions connected to wastes composition, biodegradability, and the kinetics of the anaerobic process when complex materials are utilized in ternary and quaternary mixture, specifically when co-digesting solid cattle slaughterhouse waste with agrowaste. It is therefore important to select the right combination of substrates and ratios to obtain synergy instead of antagonism in those mixtures. This chapter aims to provide an overview of the anaerobic digestion of solid slaughterhouse waste and agrowaste, as well as the influence of mixture interactions on its biodegradation.",signatures:"Ileana Pereda Reyes, Jhosané Pagés Díaz and Ilona Sárvári Horváth",downloadPdfUrl:"/chapter/pdf-download/48997",previewPdfUrl:"/chapter/pdf-preview/48997",authors:[{id:"173935",title:"M.Sc.",name:"Jhosané",surname:"Pagés-Díaz",slug:"jhosane-pages-diaz",fullName:"Jhosané Pagés-Díaz"},{id:"173936",title:"Dr.",name:"Ileana",surname:"Pereda-Reyes",slug:"ileana-pereda-reyes",fullName:"Ileana Pereda-Reyes"},{id:"173990",title:"Dr.",name:"Ilona",surname:"Sárvári Horváth",slug:"ilona-sarvari-horvath",fullName:"Ilona Sárvári Horváth"}],corrections:null},{id:"48965",title:"Organic Matter Biodegradation by Bacterial Consortium under Metal Stress",doi:"10.5772/60980",slug:"organic-matter-biodegradation-by-bacterial-consortium-under-metal-stress",totalDownloads:1874,totalCrossrefCites:0,totalDimensionsCites:2,hasAltmetrics:0,abstract:"Organic matter biodegradation proceeds via multiple enzymatic reactions, involving different oxidants as well as a number of intermediate compounds. Microbial reworking of organic matter can result in a substantial microbial contribution to the total organic matter pool. The investigations of the mechanisms, which can alter the microbial metabolism in marine sediments, are essential for understanding diagenetic processes, especially at those environments with toxic metal concentrations. Metals can bind with cells components, affecting their functioning. Consequently, the organic matter oxidation in the cellular metabolism may be affected. By contrast, the carbon sources are discriminated between labile and refractory organic compounds. The labile portion of organic matter mainly consists of biopolymers and includes carbohydrates, lipids, and proteins. The aim of this chapter is to present the main results of 10 years of studies regarding the organic matter oxidation by bacterial consortia under toxic metal levels on a tropical estuarine environment surrounded in part by mangrove areas. As the main find, the chronic dominance of lipids and carbohydrates at estuaries and mangroves systems may change the bacterial trophic state from aerobic to anaerobic metabolism. This alteration may reflect on decreasing both bacterial efficiency of organic matter degradation and bacterial productivity. Further, when these systems show high levels of metals at the sediment, the metabolic efficiency is even lower because, although bacteria consortia is able to produce extracellular polymeric substances (EPS) as defense mechanism, multimetal contamination may hinder bacterial organic matter oxidation through dehydrogenase activity inhibition.",signatures:"Simone Pennafirme, Inaya Lima, José Bitencourt, Mirian Crapez and\nRicardo Lopes",downloadPdfUrl:"/chapter/pdf-download/48965",previewPdfUrl:"/chapter/pdf-preview/48965",authors:[{id:"59687",title:"Dr.",name:"Ricardo",surname:"Lopes",slug:"ricardo-lopes",fullName:"Ricardo Lopes"},{id:"174456",title:"Prof.",name:"Inaya",surname:"Lima",slug:"inaya-lima",fullName:"Inaya Lima"},{id:"174464",title:"MSc.",name:"Simone",surname:"Pennafirme",slug:"simone-pennafirme",fullName:"Simone Pennafirme"},{id:"174465",title:"Prof.",name:"Mirian",surname:"Crapez",slug:"mirian-crapez",fullName:"Mirian Crapez"},{id:"174467",title:"Dr.",name:"José Augusto Pires",surname:"Bitencourt",slug:"jose-augusto-pires-bitencourt",fullName:"José Augusto Pires Bitencourt"}],corrections:null},{id:"48926",title:"Biodegradation of Paclobutrazol — A Plant Growth Regulator Used in Irrigated Mango Orchard Soil",doi:"10.5772/60818",slug:"biodegradation-of-paclobutrazol-a-plant-growth-regulator-used-in-irrigated-mango-orchard-soil",totalDownloads:1980,totalCrossrefCites:2,totalDimensionsCites:6,hasAltmetrics:0,abstract:"Paclobutrazol (PBZ), [2RS,3RS]-1-[4-chlorophenyl]-4,4-dimethyl-2-(1H-1,2,4-triazol-1-yl) pentan-3-ol, consists of a triazole ring and a benzene ring-chloro linked to a carbon chain open. It is a plant growth regulator widely used in many crops in order to produce fruit throughout the year by inhibiting gibberellin synthesis, a hormone responsible for the vegetative plant growth. Actually, studies are showing that paclobutrazol remains active in the soil for a long time, affecting the growth and development of subsequent crops by reducing plant vigor. Biodegradation is an effective and cheap process that can to degrade or transform contaminants to less toxic or nontoxic. In this work, the biodegradation of paclobutrazol was studied using in submersed culture and saturated and unsaturated soils. In these conditions, experiments with biostimulation and bioaugmentation were performed. In the experiments carried out in submersed culture, with biostimulation by addition of glycerol, the PBZ biodegradation was higher than that with PBZ as sole carbon source. The biodegradation of PBZ in unsaturated soils was more efficient when soil samples with a history of application of PBZ were used. The highest number of applications of PBZ favored biodegradation. The biodiversity of the microbiota in the soil favored the biodegradation of PBZ aromatic rings. PBZ was not seen to be phytotoxic and the biodegraded products increased the germination index.",signatures:"Fernanda Vaz, Ednaldo Santos-Filho, Suzyane Silva, Silvany Araújo,\nThatiana Stamford-Arnaud, Andrea Bandeira, Ana Cristina\nBrasileiro-Vidal, Newton Pereira Stamford, Maria Aparecida Mouco\nand Ester Gouveia",downloadPdfUrl:"/chapter/pdf-download/48926",previewPdfUrl:"/chapter/pdf-preview/48926",authors:[{id:"73324",title:"Prof.",name:"Newton",surname:"Stamford",slug:"newton-stamford",fullName:"Newton Stamford"},{id:"113733",title:"Prof.",name:"Ester",surname:"Gouveia",slug:"ester-gouveia",fullName:"Ester Gouveia"},{id:"160856",title:"Dr.",name:"Ana Christina",surname:"Brasileiro-Vidal",slug:"ana-christina-brasileiro-vidal",fullName:"Ana Christina Brasileiro-Vidal"},{id:"174383",title:"Dr.",name:"Fernanda",surname:"Vaz",slug:"fernanda-vaz",fullName:"Fernanda Vaz"},{id:"174384",title:"MSc.",name:"Ednaldo Amaro",surname:"Santos-Filho",slug:"ednaldo-amaro-santos-filho",fullName:"Ednaldo Amaro Santos-Filho"},{id:"174385",title:"Dr.",name:"Thatiana",surname:"Stamford-Arnaud",slug:"thatiana-stamford-arnaud",fullName:"Thatiana Stamford-Arnaud"},{id:"174386",title:"Dr.",name:"Maria Aparecida",surname:"Mouco",slug:"maria-aparecida-mouco",fullName:"Maria Aparecida Mouco"},{id:"175594",title:"BSc.",name:"Suzyane",surname:"Silva",slug:"suzyane-silva",fullName:"Suzyane Silva"},{id:"175595",title:"Dr.",name:"Andrea",surname:"Bandeira",slug:"andrea-bandeira",fullName:"Andrea Bandeira"},{id:"175596",title:"BSc.",name:"Silvany",surname:"Araújo",slug:"silvany-araujo",fullName:"Silvany Araújo"}],corrections:null},{id:"48964",title:"Biodegradation of Aromatic Compounds",doi:"10.5772/60894",slug:"biodegradation-of-aromatic-compounds",totalDownloads:3216,totalCrossrefCites:5,totalDimensionsCites:8,hasAltmetrics:0,abstract:"Polycyclic aromatic hydrocarbons (PAHs) are ubiquitous persistent environmental contaminants generated by natural combustion processes and human activities. PAHs are considered hazardous because of cytotoxic, mutagenic, and carcinogenic effects. Sixteen individual PAH compounds have been identified as priority pollutants by the United States Environmental Protection Agency (U.S. EPA). All substances originated in to the environment by either biogenic or anthropogenic sources. Anthropogenic compounds describe synthetic compounds, and compound classes as well as elements and naturally occurring chemical entities which are mobilized by man’s activities. In the marine environment, the fate of pollutants is largely determined by biogeochemical process. Some of these chemical changes enhance the toxicity of the pollutants. Other chemical changes cause the degradation or immobilization of pollutants and, as a result, act to purify the waters. Possible fates for PAHs, released into the environment, include volatilization, photo-oxidation, chemical oxidation, bioaccumulation and adsorption on soil particles, leaching, and microbial degradation. Elevated concentrations of polycyclic aromatic hydrocarbons (PAHs) have been found in mangrove sediments due to anthropogenic compounds.",signatures:"Mehdi Hassanshahian, Moslem Abarian and Simone Cappello",downloadPdfUrl:"/chapter/pdf-download/48964",previewPdfUrl:"/chapter/pdf-preview/48964",authors:[{id:"163666",title:"Dr.",name:"Mehdi",surname:"Hassanshahian",slug:"mehdi-hassanshahian",fullName:"Mehdi Hassanshahian"}],corrections:null},{id:"48996",title:"Advantages and Limitations of Using FTIR Spectroscopy for Assessing the Maturity of Sewage Sludge and Olive Oil Waste Co-composts",doi:"10.5772/60943",slug:"advantages-and-limitations-of-using-ftir-spectroscopy-for-assessing-the-maturity-of-sewage-sludge-an",totalDownloads:2869,totalCrossrefCites:5,totalDimensionsCites:14,hasAltmetrics:0,abstract:"Composts prepared using different solid and liquid organic wastes from various sources can be used as growing media when these materials present adequate proprieties for plant development. The stability and maturity are among the main characteristics of composts. The purpose of this study is to recommend specific bands of the IR spectrum recorded on different composts to enable qualitative and rapid monitoring of the stages of biodegradation during composting. At the beginning of humification, the significant decrease in the intensity of the band located at 1735 cm–1 shows that lignin is affected at the first stage of the composting process. At the end of the humification, the band located toward 3450–3420 cm–1 at the beginning of the process undergoes a systematic shift (Δν of the order of 10 cm–1) toward lower wave numbers. The band located at 1660–1650 cm–1 on the Fourier transform infrared spectroscopy (FTIR) spectra before composting shifts systematically toward 1640 cm–1 at the end of humification. This phenomenon can be used as index of compost maturity. Measuring the band at 1035 cm–1 as an internal standard, it is possible to quantify the degradation rate of organic matter.",signatures:"Loubna El Fels, Mohamed Zamama and Mohamed Hafidi",downloadPdfUrl:"/chapter/pdf-download/48996",previewPdfUrl:"/chapter/pdf-preview/48996",authors:[{id:"164092",title:"Prof.",name:"Mohamed",surname:"Hafidi",slug:"mohamed-hafidi",fullName:"Mohamed Hafidi"},{id:"175610",title:"Dr.",name:"Loubna",surname:"El Fels",slug:"loubna-el-fels",fullName:"Loubna El Fels"},{id:"175611",title:"Prof.",name:"Mohamed",surname:"Zamama",slug:"mohamed-zamama",fullName:"Mohamed Zamama"}],corrections:null},{id:"49732",title:"Biodegradation of Petroleum-Polluted Soils Using CNB-Tech – The Nigerian Experience",doi:"10.5772/62116",slug:"biodegradation-of-petroleum-polluted-soils-using-cnb-tech-the-nigerian-experience",totalDownloads:2883,totalCrossrefCites:0,totalDimensionsCites:0,hasAltmetrics:0,abstract:"Remediation of petroleum-hydrocarbon-polluted soil via biodegradation process is viewed globally as an environmentally friendly process. In this study, an overview of past and present field-scale petroleum hydrocarbon biodegradation techniques utilized in Nigeria was conducted using the tools of literature review and field survey. Pilot-scale biodegradation of hydrocarbons in petroleum-impacted clay soil of up to 42-year-long contamination using novel and eco-safe CNB-Tech was carried out. This was followed by a comparative evaluation of crop growth performance on crude-oil-polluted soil remediated using a biodegradation technique adopted by a reputable oil company in Nigeria and the innovative CNB-Tech. The study revealed that CNB-Tech is an innovative, time-effective, cost-effective and eco-friendly bioremediation technique and has the potential to excel over some existing biodegradation procedures employed by many oil industries especially in the developing countries.",signatures:"Iheoma M. Adekunle, Nedo Osayande and Temitope T. Alawode",downloadPdfUrl:"/chapter/pdf-download/49732",previewPdfUrl:"/chapter/pdf-preview/49732",authors:[{id:"77235",title:"Dr.",name:"Iheoma Mary",surname:"Adekunle",slug:"iheoma-mary-adekunle",fullName:"Iheoma Mary Adekunle"}],corrections:null}],productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},subseries:null,tags:null},relatedBooks:[{type:"book",id:"3569",title:"Biodegradation",subtitle:"Life of Science",isOpenForSubmission:!1,hash:"bb737eb528a53e5106c7e218d5f12ec6",slug:"biodegradation-life-of-science",bookSignature:"Rolando Chamy and Francisca Rosenkranz",coverURL:"https://cdn.intechopen.com/books/images_new/3569.jpg",editedByType:"Edited by",editors:[{id:"165784",title:"Dr.",name:"Rolando",surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3540",title:"Biodegradation",subtitle:"Engineering and Technology",isOpenForSubmission:!1,hash:"0ee069d311f4d412f6bbf7180e3a8ea4",slug:"biodegradation-engineering-and-technology",bookSignature:"Rolando Chamy and Francisca Rosenkranz",coverURL:"https://cdn.intechopen.com/books/images_new/3540.jpg",editedByType:"Edited by",editors:[{id:"165784",title:"Dr.",name:"Rolando",surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3570",title:"Biodegradation of Hazardous and Special Products",subtitle:null,isOpenForSubmission:!1,hash:"29ce0f4a059cb02b060a2b4082ca81e0",slug:"biodegradation-of-hazardous-and-special-products",bookSignature:"Rolando Chamy and Francisca Rosenkranz",coverURL:"https://cdn.intechopen.com/books/images_new/3570.jpg",editedByType:"Edited by",editors:[{id:"165784",title:"Dr.",name:"Rolando",surname:"Chamy",slug:"rolando-chamy",fullName:"Rolando Chamy"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"3426",title:"Organic Pollutants",subtitle:"Monitoring, Risk and Treatment",isOpenForSubmission:!1,hash:"4dafb52ed4f5e21f079ab4b2f6825e78",slug:"organic-pollutants-monitoring-risk-and-treatment",bookSignature:"M. 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In spite that the generation and transmission of electric power are done by means of the three‐phase ac system, today, the development of the two‐phase system is still continued mainly to split‐single‐phase IM motor supply that is documented in this chapter and given references. So, the first venture into the realm of polyphase electric power has used only two alternating current phases rather than three but with pulsating power flow to motor in contrast to constant power of three‐phase system [1]. In regard to topologies of the two‐phase inverters, mostly three‐leg ones with six switches or two legs with four switches are used. Evaluation of low‐cost topologies for the two‐phase induction motor (IM), which drives in an industrial application, is analyzed and discussed in Refs. [2–4]. Half‐bridge two‐phase voltage source inverters (VSI) for two‐phase (IM) supply are described in Refs. [5–8]. Besides, there exists also a possibility to supply three‐phase induction motor by the two‐phase inverter [9].
\nRegarding to minimum switching devices, two‐phase one‐leg VSI inverters for the two‐phase IM supply, there are works of Chomat et al. in Refs. [10–12]. In those, the operation of the motor at nominal frequency is different from the reduced frequency operation when phase shift of auxiliary phase is provided by a capacitor. Due to variable load, it is useful to change the value of capacitance in auxiliary phase, so the electronically switched capacitor techniques are used [13, 14]. Current pulse‐width‐modulation (PWM) or space vector modulation (SWM) provides demanded sinusoidal waveform and feedback control [15, 16].
\nA new original topology of single‐leg direct matrix converter was first published by authors of this chapter in Ref. [17] based on the works in Refs. [10, 18]. The number of switches is minimized, but total harmonic distortion (THD) of auxiliary‐phase voltage is very high (86% at 50 Hz, 69% at 33.33 Hz) and consequently current distortions too (68 and 43%, respectively). Therefore, the improved two‐phase one‐leg matrix converter is completed by an LC filter [19] designed by Dobrucký et al. [20]. Combination of tuned LC filter and switched capacitor brings a new quality of output quantities of converter, which provides acceptable THD and makes possible field‐oriented control (FOC) of the IM motor.
\nThe chapter is organized as follows. First, the basic topologies of one‐, two‐, three‐, and four‐leg VSI inverters for two‐phase application are described. Next, the special topologies using matrix inverters for two‐phase application are introduced. Possibilities of use of switched capacitor for auxiliary circuit phase control providing the use of LC filter are described, and simulation study of Matlab/Simulink and LT Spice with passive RL and active motoric loads are given. Afterward, current controlled PWM (or hysteresis control) is worked out, and finally, conclusion is described.
\nThe topology (Figure 1) consists of four semiconductor switches. A low number of a semiconductor switches is the main advantage of the topology. Those switches create two half‐bridge inverters, each of them powers one of the windings. The disadvantage, which this topology suffers from, is low magnitude of the output voltage. It is half of an interlink DC voltage in Refs. [2, 21]. Another disadvantage is hidden in control of the switches, which is only bipolar PWM can be used [6], which has further negative consequences.
\nVoltage source inverter with two legs.
It is also possible to supply three‐phase IM motor by two‐phase VSI inverter [9], Figure 2.
\nVoltage source inverter with two legs for supply of three‐phase IM.
In opposite, there is also a possibility to supply two‐phase IM by three‐phase three‐leg inverter (at the next).
\nThe topology shown in Figure 3 consists of six semiconductor switches. Two of the three-leg are used for the power supply of the motor windings and third leg is used for creation of common phase of the motor [2, 21]. As a control of the switches, the modified SPWM [6, 22] can be used to describe the use of sin(
Voltage source inverter with three legs.
Another possible topology that can be used to fed the two‐phase induction motor (Figure 4) is created by eight switches. Each phase is fed by one full‐bridge inverter.
\nVoltage source inverter with four‐leg and four‐output terminals.
The topology uses a larger amount of switches (eight ones), and therefore, the topology is able to use entire magnitude of DC interlink voltage [7, 21].
\nModel of two‐phase IM motor is well known [7–9, 13, 14]. So, the electric machine being considered may be described by the following set of ordinary differential equations in the
where
As control methods, it can be used modern control ones: field‐oriented vector control as well as space vector pulse width modulation [6, 15]. Some results of operation of two‐phase IM supply are shown in Figure 5a, start‐up and steady state (b).
\nBehaviour of two‐phase IM supplied by two‐phase VSI inverter; (top) start‐up and (bottom) steady‐state operation [
The topology VSI with two legs controlled by SVPWM is able to turn on a four active voltage vector but not able to turn on a zero voltage vector, which is its major disadvantage [21].
\nSubstituting VSI topology by matrix one will be able to turn on eight active voltage space vectors with turn‐on times as shown in Figure 6 (top) but still no zero space vectors, Figure 6 (bottom).
\nTwo‐leg VSI; (top) turn‐on times of active voltage vectors and (bottom) creating SVPWM [
Instead of VSI inverters with two, three, and four legs, there can be used matrix converter [21], but the number of switching devices is rather higher, nearly two times.
\nMinimum of switching devices: two switches for inverter, two diodes for rectifiers, are reached by the one‐leg VSI inverter [8, 10], Figure 7.
\nSchematic of one‐leg VSI inverter [
Anyway, it also needs two antiparallel diodes and two bulky capacitors. Schematic of VSI in Figure 7 is dedicated for ac motors. In full speed operation, the one leg of VSI with switches provides phase shift of 90°, since in reduced speed operation, the shift is created by a capacitor.
\nInstead of one‐leg VSI inverters that can be used matrix converters is based on single‐phase matrix converter. The matrix converter has some specific advantages over voltage source inverter in the size of the device, the lack of intermediate circuit, and also reduction in needed capacity [18]. The disadvantages are higher cost and also higher number of switching elements. Matrix converter that consists of just one single leg is described as original one, in Section 4.
\nOne possibility for the first stage is to use a resonant converter, for instance an LCL2C2 resonant converter, Figure 8a. The second stage can be created as a two‐leg two‐phase matrix converter. This resonant converter consists of four bidirectional switches. For his control, an SVPWM modulation can be used, which is very like of SVPWM modulation for two‐phase two‐leg voltage VSI inverter.
\nTwo‐stage MxC; (a) with resonant converter as a first stage and (b) its space vectors [
The difference is the need to monitor the voltage polarity in an intermediate circuit and properly toggle the combination of active vectors. Unlike the two‐phase two‐leg voltage source inverter, the two‐phase two‐leg matrix converter has double number of active vectors, Figure 8b. It is necessary to switch on the active vectors V1–V4 when the voltage in intermediate circuit is positive. If there is a negative voltage in the intermediate circuit, vectors V5–V8 are switched on. Reference voltage for the switches is shown in Figure 9.
\nWaveforms of reference voltages for two‐phase matrix converter [
The operation of matrix converter with motoric load in an open‐loop operation and detail of stator currents and adequate stator voltages during two periods at steady state are shown in Figure 10.
\nStator voltages and stator currents of α‐phase during two periods [
Anyway, number of switching devices using two‐phase LCL2C2 inverter with two‐leg matrix converter is still high (2 + 4 that means six switches).
\nAnother possibility how to reduce number of switching devices is presented by the special connection of one-leg matrix converter supplied direct from the network. As new type of two‐phase converters using matrix converter for two‐phase applications has been developed for single‐leg matrix converter [17].
\nA novel supply system for two‐phase induction motor by a single‐leg matrix converter was introduced in work [17] using principle of
One‐Leg MxC; (a) schematics for full speed at 50 Hz and (b) for reduce speed (<50 Hz) [
In the circuit operation of full speed regime, the voltage of auxiliary phase is possible to express as
\nFor reduced speed, the voltage of both main and auxiliary phases is expressed as
\nThe input and output waveforms of MxC in full speed mode and reduced speed mode are shown in Figures 12 and 13. The switching logic of the control system that creates the desired output voltage from input voltage is shown in Figure 14.
\nVoltages of SLMxC in full speed mode 50 Hz; (top) input network voltage and (bottom) SLMxC output voltage.
Voltages of SLMxC in reduced speed mode 6.66 Hz; (top) input and (bottom) output voltages.
The switching logic for main and auxiliary phases.
Among various questions, the first question is how value of the fundamental harmonic of auxiliary phase will reached. Using Fourier analysis of the one fourth of the waveform, Figure 15, one can write equations:
\nTo harmonic analysis for the first part of the waveform.
Definite relations
\nThen
\nFundamental harmonic waveform
\nAfter calculation
\nThe value if fundamental harmonic at the middle of half‐period
\nThe contribution from the second part of auxiliary‐phase waveform will be the same, Figure 16. So, this means that maximal magnitude of auxiliary‐phase fundamental harmonic is
\nAuxiliary-phase waveforms; (solid) total wave, (dashed) fundamental harmonic and (dotted) sum of higher harmonics.
Thus, the RMS value of the output voltage of the one‐leg converter should be two times greater than requested voltage of the main phase of the system.
\nBasic scheme of MxC converter for reduced speed is different from full speed and given in Figure 11b. The phase shift of auxiliary phase is provided by the capacitor
Vector diagram for reduce speed of auxiliary‐phase impedances.
By calculating
There is equality of
Analytical differential equations for main‐ and auxiliary‐phase state‐space variables (Figure 11b) are:
\nwhere
After time discretization (e.g. using Euler\'s method), we obtain discrete dynamic model suitable for simulation in Matlab/Simulink.
\nSimilar to one‐leg VSI inverter [8, 12], the number of switches of single‐leg MxC is minimized but total harmonic distortion auxiliary‐phase voltage is very high (86% at 50Hz, 69% at 33.33 Hz) and consequently current distortions too (68% and 43%, respectively), see Figure 18 in Section 6 for simulation results where Figure 18a is for 50 Hz and Figure 18b is for 33.33 Hz.
\nOne‐Leg MxC; (a) voltage and current of auxiliary‐phase at 50 Hz and (b) at 33.33 Hz.
Due to very high THD of the main and auxiliary voltages and current, there is a problem regarding to electromagnetic torque generated by two‐phase IM motor. Therefore, neither the operation at 50 Hz nor at reduced frequency (33.33 or 25 Hz), under nominal torque and during start‐up, could be provided successfully.
\nThus, we have to accept some measures for successfully operating PWM control, adding LC resonant filter, and/or using switched capacitor.
\nParameters of the two‐phase IM used for simulation are therefore given in Section 5 with PWM controlled motor.
\nThus, it is necessary to improve current waveforms. Current‐controlled PWM modulation (CC‐PWM) for full‐speed operation is not possible to use because of decreasing of auxiliary‐phase voltage. Other possibility that has been used is using of LC resonant circuit that can be used both in auxiliary and main‐phase circuits, Figure 19a and b.
\nSchematics of SLMxC; (a) for full speed at 50 Hz and (b) for reduce speed (<50 Hz) with LC circuits.
Analytical differential equations for main‐ and auxiliary‐phase state‐space variables (Figure 19b)
\nwhere
After time discretization (e.g. using Euler\'s method), we obtain discrete dynamic model suitable for simulation in Matlab/Simulink.
\nAfter realization of above measures, the total harmonic distortion of main and auxiliary‐phase currents will be much better such as 12.47% at 50 Hz and 8.47% at 33.33 Hz with LC circuits, see Figure 20a for 50 Hz and Figure 20b for 33.33 Hz in Section 6. By suitable design of LC elements [20], it is possible to reach the best value of main‐and auxiliary‐phase current THDs (<5%) but the size of the LC elements will be rather high.
\nVoltage and current of auxiliary‐phase at 50 Hz (a) and at 33.33 Hz (b) with additional LC circuit.
Resonant LC filter can be tuned either for given frequency 50 Hz, schematic in Figure 19a, or for ‘quadratic mean’ frequency band 33.33 Hz, schematic in Figure 19b. Design of LC filter has been done using design procedure by Dobrucký et al. [20].
\nAuxiliary‐phase advancing using switched C or L elements can be provided by different ways [13, 14]
\n- switched capacitor with four switches networks, Figure 21a
- switched capacitors with two switches and two capacitors, Figure 21b
- switched RLC (inductor and capacitor) circuit with two switches connected as series network, Figure 21c
- switched inductor with two switches connected as parallel network, Figure 21d
Possibilities of switched capacitor networks for phase shift control.
Since first two possibility items operate with full controlled bidirectional switches the later two can be operated by ordinary thyristors with uncontrolled switching‐off of the circuit current.
\nA periodically reversed switched capacitor is connected in series with an RL load supplied from a sinusoidal voltage source. To control the phase of the fundamental component of load current, a suitable algorithm for the switching of the capacitor is derived and tested. The operation of the switch pairs is complementary and supports a pulse width modulated regime where the duty factor of the dominant pair, e.g. S1, is restricted to vary between 0.5 and unity.
\nWe have chosen a variant shown in Figure 21b because of variant Figure 19a that needs high number of switches and variants Figure 19c and d operate with uncontrolled switching‐off of the circuit current only, with an auxiliary winding through the bidirectional choppers S1 and S2 controlled by PWM with a frequency of about 1 kHz. The capacitance is changed by variation of the duty cycle
\nfrom 0 to 1.
\nThe switches S1, S2 are linked with each other by an inverted logic. One capacitor has high capacitance and the other has low capacitance. The desired capacitance is set as a function of duty cycle for the switching between these two capacitors.
\nThe equation for the controlled switched capacitance
From Fourier analysis, the dc component of periodic waveform is equal to its average value
\nwhere
Then, the total energy stored in the two capacitors is
\nThus,
\nAfter further simplification, we get the final equation for the switched capacitance as the function of duty cycle
\nThe absolute value of the auxiliary impedance
Combining Eq. (21) for the auxiliary‐phase capacitance
and
\nFinding the roots of the quadratic equation we get the duty cycle
In a similar way, we can derive a switching capacitor for the resonant filters,
Again, combining Eq. (41) for resonant capacitance with Eq. (35) for the switching capacitance
and
\nOn solving the equation, we get similar equation for control of resonant frequency
\nSwitched capacitor will provide a requested phase shift of 90°. Requested waveforms shape should be provided by an additional LC resonant filter [19].
\nAccepting of measures mentioned in Sections 4.3 and 4.4, it is possible essentially to improve quality of SLMxC. Combining switched capacitor in auxiliary phase and using LC resonant filter between the center tape of SLMxC and neutral point, it will be possible to obtain demanded current waveforms with lower value of total harmonic distortion of both main and auxiliary phases.
\nWorked‐out simulation results are given in Section 6. At first, the simulation results of SLMxC with switched capacitors and LC filter under RL load are given in Figure 22a for 50 Hz, Figure 22b for 33.33 Hz, Figure 23a for 25 Hz and Figure 23b for 10 Hz.
\nMain‐ and auxiliary‐phase steady‐state current (top) and SLLC MxC output voltage (bottom); (a) at 50 Hz and (b) at 33.33 Hz.
Main‐ and auxiliary‐phase steady‐state current (top) and SLLC MxC output voltage (bottom) at 25 Hz (c), and 10 Hz (d).
Simulation results of SLMxC with switched capacitors and LC filter under motoric IM load are shown in Figures 24–26 in Section 6. There are shown steady‐state currents and voltages of main and auxiliary phases in Figure 24 at 50 Hz, in Figure 25 at 33.33 Hz with PWM control, and also start‐up operation in Figure 26.
\nMain‐ and auxiliary‐phase steady‐state current of two‐phase IM (top) and SLLC MxC output voltage (bottom) at 50 Hz without PWM.
Main‐ and auxiliary‐phase steady‐state current of two‐phase IM (top) and SLLC MxC output voltage (bottom) at 33.33 Hz with PWM.
Main‐ and auxiliary‐phase current of two‐phase IM supplied by SLLC MxC during start‐up.
Simulation results, Figure 27, were worked‐out without LC filter and switched capacitor [15].
\nCurrents controlled by hysteresis control; (a) in common phase and (b) in auxiliary phase [
Parameters used for the simulation with an induction machine:
\nIt can be seen that the waveforms of currents of main and auxiliary phases are not shaped sufficiently. Further improving would be possible using mentioned measures, i.e. LC filter and switched capacitor.
\nBasic single‐leg MxC schematic is given in Figure 11a and b. As mentioned in Section 4.2, there is a problem regarding to an electromagnetic torque generated by two‐phase IM motor due to very high THD of the main and auxiliary voltages and current. Therefore, neither the operation at 50 Hz nor at reduced frequency (33.33 or 25 Hz), under nominal torque and during start‐up, could be provided successfully.
\nParameters used for the simulation with the induction machine (the same as above):
\nSimulation results without LC filter and switched capacitor are given in Figure 28.
\nStator currents of a single‐phase induction motor fed by single‐leg MxC; (a) in full‐speed operation, and (b) reduced speed operation without LC filter and switched capacitor [
Currents are also highly deformed in both full‐speed and reduced‐speed regimes. In 4.5 seconds, it has changed the operation mode from full speed into reduced speed; speed of motor is proportional to the frequency of stator voltage of 25 Hz. Moreover, the start‐up of the IM is not being successful. So, the main problem of single‐leg matrix converter is high distortion of auxiliary‐phase voltage and currents.
\nThe basic principle of used current controlled PWM feedback loop is given in Figure 29.
\nPrinciple of used CC‐PWM feedback loop of single‐leg MxC.
The resonant parts,
Finally, combined solution with LC additional circuits and the current controlled PWM (hysteresis CC PWM) with current feedback closed loop is the best one. As mentioned in Section 4.2, simulation results of SLMxC with switched capacitors and LC filter under motoric IM load with PWM control are shown in figures in Section 6. There are shown steady‐state currents and voltages of main and auxiliary phases in Figure 25 at 33.33 Hz
\nUsing this solution, the total harmonic distortion of main‐ and auxiliary‐phase currents will be smaller than usually requested value of 5%.
\nExcept the phase angle control, the amplitude of the phase currents must be controlled to optimal FOC operation of the induction machine under different load conditions.
\nAll simulations of SLMxC with RL load were worked out in LT Spice environment. All simulations of SLMxC with motoric IM load were done in Matlab/Simulink programming environment.
\nMain‐ and auxiliary‐phase steady‐state currents and SLLC MxC output voltages have been worked‐out at different frequencies 50/33.33/25/10 Hz.
\nThe simulated phase currents under the RL load show that by control of switched capacitor the exact value of demanded capacitance is reached. Then, the phase angle between the mentioned current is also equal 90° as in Figure 17. From the Figures 22–25, it is obvious that this condition is satisfied.
\nSimulation of steady‐state and start‐up operation of two‐phase IM is given in Figures 24–26. The simulation was done both with switched capacitor and LC resonant filter (except 50 Hz). Parameters are used for simulation with the induction machine:
\nThe simulated phase currents of the two‐phase induction machine show that by control of switched capacitor reaches exact value of capacitance which in case of that the phase angle between the mentioned current is also equal 90°. The effect of the filter in a common phase will result in nearly the same magnitude of the IM currents during start‐up; however, the time during start‐up is rather longer.
\nThe chapter brings analysis, modeling, and computer simulation of two‐phase inverters focused on minimum switching devices. There are described two main types of switching devices: the single‐leg VSI inverter partially known from a literature and single‐leg MxC matrix converter as a new one. Since one‐leg matrix converter type features a non‐harmonic current waveform, the main emphasis is laid on the enhancement to their shapes. Because the use of classical PWM technique is restricted by insufficiency of voltage under basic frequency operation, it is necessary to use an additional hardware LC resonant circuit. After realization of above measures with LC filter, the total harmonic distortion of main‐ and auxiliary‐phase currents will be much better: about 12% at 50 Hz and circa 9% at 33.33 Hz with LC circuits, see Figure 24 in the text. By suitable design of LC elements, it is possible to reach the best value of the main‐ and auxiliary‐phase current THDs (<5%) but the size of the LC elements will be high. Using that solution the total harmonic distortion of main‐ and auxiliary‐phase currents will be smaller than usually requested value 5%. Analysis and worked‐out simulation experiment results under RL load have shown that use of the LC filter can significantly improve the harmonic of the current waveform in both main‐ and auxiliary‐phase windings. It should be also noticed that the simple LC resonant tank is always tuned to single frequency only and therefore the right operation of the MxC converter is also limited to this one frequency. To eliminate this disadvantage, the switched capacitor is supposed to use the capacitance that can be continuously changed and adapted to actual requirement given by an operational frequency. It is very important under field‐oriented control of split‐single‐phase induction motor as a load for the converter. The basic topology has been completed by the LC filters that have both currents of main and auxiliary phases approximately sinusoidal waveforms. Main contribution of the paper is combined with the control of auxiliary phase advancing to be 90 degree under entire range of load operation and also pulse‐width‐modulation for field‐oriented control.
\nSimulation experiments have been done using passive RL load and also split‐winding single‐phase IM motor. Worked‐out results under RL load operation have shown very good agreement with theoretical assumptions. Worked‐out results under split‐winding single‐phase IM motoring operation are just preliminary ones because it needs accurate real motor parameters and takes longer time. Cooperation of switched capacitor single‐leg LC matrix converter with split‐winding single‐phase IM is intended as for next work. The results reached can be served for usage and analysis of systems with two‐phase ac motor drive. So, the next work is to focus on motoric load operation.
\nResults of this work were made with support of the Slovak Grant Agencies VEGA by the grant no. 1/0928/15 and APVV no. 0314/12. Authors also thank to the R&D operational program Centre of excellence of power electronics systems and materials for their components no. OPVaV‐2008/01‐SORO, ITMS 2622012003 funded by the European regional development fund (ERDF).
\nLCL2C2 | Center tapped series‐parallel resonant LC filter |
THD | Total harmonic distortion |
VSI | Voltage source inverter |
MxC | Matrix converter |
PWM | Pulse‐width‐modulation |
SVPWM | Space vector pulse‐width‐modulation |
IM | Induction motor |
DC | Direct current |
MOSFET | Metal‐oxide‐semiconductor field‐effect transistor |
CC‐PWM | Current controlled pulse‐width‐modulation |
FOC | Field‐oriented control |
uaux | Converter output voltage for auxiliary phase |
umxc | Converter output voltage common for main and auxiliary phase |
UM | Voltage magnitude |
fmxc | Frequency of matrix converter output voltage |
fac | Frequency of matrix converter input voltage |
Tmxc | Period of matrix converter output voltage |
Tac | Period of matrix converter input voltage |
Zmain | Impedance of main phase |
Zaux | Impedance of auxiliary phase |
Caux | Capacitance in auxiliary phase |
Cres | Capacitance in resonant filter |
Lres | Inductance in resonant filter |
A1 | Fundamental harmonics amplitude |
Dtc | Duty cycle |
E | Energy |
Rs | Resistance of IM stator winding |
Rr | Resistance of IM rotor winding |
Ls | Inductance of IM stator winding |
Lr | Inductance of IM rotor winding |
Lm | Mutual inductance |
Te | Electromagnetic torque |
ωm | Mechanical angular speed |
pp | Number of pole pairs |
N | Ratio between the effective numbers of turns in the auxiliary and the main stator windings |
Intracellular and blood potassium levels have crucial effects on cardiovascular system homeostasis. At the most fundamental level, the potassium concentration gradient across cardiac muscle cell (cardiomyocyte) cell membranes is a chief determinant of cardiomyocyte resting membrane potentials. Indeed, disruptions to this concentration gradient (e.g. via increasing or decreasing extracellular blood potassium levels) can lead to altered cardiomyocyte contractility and excitability. Potassium is also vasoactive, with different effects at different extracellular concentrations. At low (5-8 mM) to moderate (8-16 mM) extracellular levels, potassium relaxes the smooth muscle in blood vessel walls by promoting hyperpolarization of vascular smooth muscle. However, at higher levels (16-25 mM and above) (e.g. cardioplegic concentrations), potassium promotes vasoconstriction by facilitating depolarization. Moreover, potassium is released by vascular endothelial cells in response to various chemical mediators and shear stress, thereby contributing to the action of endothelium-derived hyperpolarizing factor [1]. For all of these reasons and more, keeping track of daily potassium intake is often recommended as a lifestyle modification for chronic cardiovascular diseases such as hypertension.
Harnessing the pivotal role of potassium in cardiovascular physiology has proved quite useful for cardiovascular surgery, namely in the form of hyperkalemic (high potassium) cardioplegia. Indeed, throughout the past several decades, a large body of research has testified to the ability of externally administered hyperkalemic solutions to arrest cardiac contractility [2]. This, in conjunction with the development of cardiopulmonary bypass (CPB, also known as the “heart-lung machine”), revolutionized cardiac surgery [3]. These days, many highly invasive procedures like coronary artery bypass grafting are routine with minimal risk of postoperative mortality.
However, hyperkalemic cardioplegia is not without its consequences. Hyperkalemic cardioplegia and reperfusion following CPB have been associated with perioperative and postoperative tissue damage and microvascular dysfunction across several different vascular beds. Moreover, hyperkalemic cardioplegia is also associated with postoperative myocardial dysfunction and reduced cardiac output. Furthermore, blood potassium abnormalities after hyperkalemic cardioplegia-reperfusion, chiefly hypokalemia (but also hyperkalemia, to a lesser degree) are common postoperative challenges in the cardiac ICU. Both abnormalities significantly elevate the risk of arrythmias and, if not managed properly, cardiac arrest and sudden death.
This chapter will discuss the basics of potassium cardioplegia with an emphasis on clinical relevance, beginning with a brief history. Subsequent sections will elaborate on the basic physiology, before considering several perioperative and postoperative adverse effects of hyperkalemic cardioplegia. When possible, information about treatment and clinical management is included. The chapter will conclude with a brief mention of up-and-coming alternatives to hyperkalemic cardioplegia.
As early as the late 1800s, physiologists were starting to become aware of the ability of potassium compounds to arrest cardiac contractility, beginning with individuals like Sidney Ringer who observed that potassium chloride froze the heart in diastole and calcium stimulated the heart during systole [2]. Moving into the start of the 20th century, further investigations revealed associations between high serum potassium and cardiac arrest following ventricular fibrillation; studies also revealed associations between cardioplegia and restoration of sinus rhythm following coronary artery administration of potassium chloride solution and subsequent washout [2]. However, in most of these cardioplegic experiments (often conducted in dogs), refractory ventricular fibrillation and post-procedure reperfusion damage to the myocardium limited discussion of the clinical usefulness of these findings.
During the 1950s, British physician Dennis Melrose hypothesized that the problem with potassium chloride cardioplegia was chloride; therefore, he created a cardioplegic solution using potassium citrate, and tested it on a canine model of cardiopulmonary bypass [4]. Injection of the “Melrose solution”, of potassium citrate plus warm oxygenated whole blood in a 9:1 blood:potassium ratio, into the aortic roots of hypothermic dogs, produced near-immediate cardiac arrest. Reperfusion and washout of cardioplegic solution resulted in restoration of heart function to pre-procedure levels [2]. Within a few years, the Melrose group successfully induced potassium citrate cardioplegia in humans.
Unfortunately, future studies would reveal that in many cases, the Melrose potassium citrate solution still produced post-cardioplegia ventricular fibrillation and myocardial dysfunction [5]. This led to a general pause in clinical application of potassium cardioplegia between the 1960s and early 1980s, in favor of other options mostly involving induction of hypothermic cardiac arrest, which turned out to be no better with respect to postoperative damage than the Melrose solution.
Eventually, research into techniques for potassium cardioplegia would pick up again, and the result would be development of novel solutions for cardioplegia and intraoperative organ preservation. Numerous studies in animal models have validated the principles of diastolic cardiac arrest due to depolarizing potassium cardioplegia [2, 3, 6, 7, 8, 9, 10]. In addition, invention and refinement of heart-lung machines to accompany cardioplegia in the operative room (CPB) opened many new possibilities for cardiac surgery. Today, potassium cardioplegia is an integral tool for cardiac surgeons performing a variety of highly invasive procedures such as coronary artery bypass grafting and aortic valve replacements.
Despite variability in composition, delivery, and temperature, most cardioplegic solutions in use today involve some level of potassium chloride as the main inducer of cardiac arrest, along with ions such as magnesium, low-dose calcium and bicarbonate, the latter of which is particularly important for controlling solution pH [6]. The “original” hyperkalemic cardioplegic solution was the Melrose formula of the 1950s that was discussed earlier, consisting of potassium citrate and warm blood in a 9:1 blood:potassium ratio. However, due to the high incidence of postoperative complications including ventricular fibrillation, this solution is no longer in major clinical use.
In general, cardioplegic solutions fall under two broad umbrellas: crystalloid vs. blood, and warm vs. cold (Table 1). Two crystalloid cardioplegic solutions worth noting are the Custodiol (also known as Bretschneider) and St. Thomas solutions [7]. The St. Thomas solution, introduced first by Hearse and colleagues in 1975, is an example of a short acting cardioplegic solution involving potassium chloride concentrations between 10 and 30 mM [8]. In general, the St. Thomas solution requires repeat dosing, roughly every 20 minutes, to sustain cardioplegia for long durations [7, 9]. Furthermore, myocardial acidosis has been noted between doses of St. Thomas solution [10].
St. Thomas Cardioplegia | Custodiol Cardioplegia | Del Nido Cardioplegia | Buckberg Cardioplegia | Warm Calafiore Cardioplegia (one variant) | |
---|---|---|---|---|---|
K+ | 16 mM | 9 mM | 26 mM | Cold induction: 36 mM Maintenance: 36 mM Reperfusion: 15 mM | 18–20 mM for inducing arrest, repeat delivery every 20 min with decreasing K concentrations |
Ca | 1.2 mM | 0.015 mM | 1.3 mM | ||
Mg | 16 mM | 4 mM | 2 g of 50% magnesium sulfate | 15.5 mM | |
Na | 110 mM | 15 mM | |||
NaHCO3 | 10 mM | 13 mM | |||
Other Components | 18 mM Histidine hydrochloride 18 mM histidine 2 mM tryptophan 30 mM mannitol 1 mM potassium hydrogen 2-ketoglutarate | 13 mL of 1% lidocaine 3.2 g/L of 20% mannitol | 62.5 mL glutamate/aspartate | 500 mL 5% dextrose 4 mM tris(hydroxymethyl)aminomethane Core body temperature maintained at 37 degrees Celsius | |
Blood vs. Crystalloid | Crystalloid | Crystalloid | 4:1 crystalloid: blood ratio | 4:1 crystalloid: blood ratio | Normothermic blood |
Composition of common potassium-based cardioplegic solutions.
In contrast, the Custodiol solution is a form of long acting, single dose cardioplegia consisting primarily of potassium chloride, sodium chloride, and magnesium sulfate as the chief electrolytes [11]. Additional components of the Custodiol solution include tryptophan (membrane stabilization) and histidine buffer (to maintain pH and buffer against byproducts of anaerobic glycolysis that build up during cardioplegia). Curiously, the relatively low levels of potassium (9 mM) and sodium (15 mM) in Custodiol appear to induce cardioplegia through a form of hyperpolarized arrest as opposed to depolarized arrest, unlike most other potassium cardioplegic solutions that have potassium concentrations in the range of 16-36 mM and sodium concentrations in the range of 10-110 mM (see Table 1 for detailed solution ion concentrations).
The general rationale for blood-based cardioplegia has centered on the theory that cardioplegic solutions containing blood are more “physiologic” than crystalloid solutions. For example, blood can support aerobic respiration and may be able to preserve normal myocardial metabolism during surgery. Therefore, blood cardioplegia may reduce the negative consequences of prolonged ischemia during CPB [11]. However, insufficient evidence exists currently to verify that hypothesis, and so any purported advantages of blood over crystalloid cardioplegia are for the time being mainly speculative.
Three hyperkalemic cardioplegic solutions in clinical use that contain blood are the Del Nido, Buckberg, and Calafiore solutions. The Del Nido solution uses a crystalloid:blood ratio of 4:1, and like the Custodiol solution is a long-acting cardioplegic solution, with one dose of 20 ml/kg providing myocardial protection for up to 60–90 minutes [7, 12]. Chief ionic ingredients include potassium chloride for rapid depolarized arrest, sodium bicarbonate to scavenge protons and buffer intracellular pH, and magnesium to block calcium channels and prevent intracellular calcium accumulation during cardioplegic arrest, thereby promoting postoperative myocardial recovery [12, 13]. Lidocaine in the Del Nido solution acts as a sodium channel blocker to mitigate against the sodium “window current” and reduce intracellular sodium accumulation [14].
Buckberg’s cardioplegia is a dextrose and saline-based solution that, similar to the Del Nido solution, consists of a crystalloid:blood ratio of 4:1 [15]. Other components include potassium chloride as the primary depolarizing agent, a tromethamine buffer, and citrate phosphate double dextrose to serve as a calcium chelator. However, unlike the Del Nido solution, Buckberg cardioplegia must be given as three separate formulations, some of which must be administered in multiple doses [15]. First, an induction solution stops the heart, and additional infusions of induction solution must be given every 15 to 20 minutes throughout the procedure. Second, a maintenance solution must be administered to sustain cardiac arrest and provide oxygen and nutrients to the cardiomyocytes. Finally, a reperfusion solution containing glutamate and aspartate is administered prior to removal of the aortic cross clamp to provide the heart with nutrients prior to restarting myocardial contractions.
Calafiore cardioplegia differs from Buckberg and Del Nido in that blood forms the sole foundation of Calafiore cardioplegic solution [16]. Indeed, the original rational proposed by Calafiore et al. was that blood alone, without any crystalloid component, contained everything necessary to prevent ischemia–reperfusion damage. Therefore, simply administering a cardioplegic solution consisting of blood plus extra potassium would be enough to safely stop and later, restart the heart [16]. Moreover, unlike most other forms of cardioplegia in use, the original Calafiore solution was normothermic throughout administration; however, some subsequent variations of Calafiore cardioplegia have used cold blood [16, 17].
Most current methods for administering cardioplegic solutions involve cold cardioplegia, most often cold crystalloid solutions delivered after reducing core body temperature to hypothermic levels [18]. For example, the induction and maintenance solutions for Buckberg cardioplegia are delivered at 4 degrees Celsius after cooling core temperature to below 30 degrees Celsius, with reperfusion solution delivered at 37 degrees Celsius [15]. Similarly, del Nido and Custodiol cardioplegia are often given at 4 degrees Celsius after induction of systemic hypothermia [15, 19].
This practice stems from experimental evidence suggesting that mild hypothermia can protect the myocardium from ischemic damage during cardioplegia [20]. Hypothermia reduces the basal metabolic rate of the heart, which in turn reduces oxygen consumption—an effect augmented by potassium-induced arrest during hyperkalemic cardioplegia [21]. A variety of potential mechanisms may be at play. In animal models of cardiac arrest, mild hypothermia (32–35 degrees Celsius) has been shown to reduce post-arrest infarct size, possibly through various signal transduction pathways, such as Akt and mTOR signaling, both of which are altered during the course of hypothermia [20]. Another potential cardioprotective mechanism of hypothermia may be reduced phosphorylation of various mitogen activated protein kinases (MAPK) like ERK1/2 that normally activate pro-inflammatory mediators like COX-2 (arachidonic acid metabolism) [18]. In general, many details concerning mechanisms of hypothermic myocardial protection during cardioplegia remain to be elucidated.
However, cold hyperkalemic cardioplegia may also inhibit myocardial enzymes that are important for the metabolic and functional recovery of the heart after surgery [22, 23]. Moreover, sustained systemic hypothermia (especially at temperatures below 20 degrees Celsius) during cardiac surgery has also been associated with ventricular fibrillation after rewarming [21]. Given these negative consequences, an increasing amount of attention has been given to the possibility of warm hyperkalemic cardioplegia, primarily warm blood hyperkalemic cardioplegia. Unlike cold hyperkalemic cardioplegic solutions, warm cardioplegic solution is typically administered at between 30 and 35 degrees Celsius under normothermic, as opposed to hypothermic, CPB [24]. Potential advantages of warm blood hyperkalemic cardioplegia over cold crystalloid may include improved myocardial restoration, reduced intracellular swelling, improved membrane stabilization, and reduced hypoxic red blood cell deformation [25].
Of course, warm hyperkalemic cardioplegia is not without its own consequences. Some studies have reported increased likelihoods of perioperative strokes and encephalopathy [26]. Moreover, warm hyperkalemic cardioplegia may contribute to vasodilation during cardiopulmonary bypass, requiring increased use of alpha agonists during operation to maintain stable arterial perfusion pressures [25]. There are also several variations of warm cardioplegia; one common technical variant is “hot shot” cardioplegia, which involves warm induction and subsequent cold cardioplegia, followed by a warm reperfusion [27].
Comparing the effectiveness of warm vs. cold hyperkalemic cardioplegia remains an inconclusive subject of intense debate. A meta-analysis by Fan et al., reported no differences between length of stay, stroke incidence, and atrial fibrillation between patients undergoing warm vs. cold cardioplegia [28]. However, warm cardioplegia correlated with better postoperative cardiac indices and lower peak creatine kinase MB concentrations than cold cardioplegia [28]. The latter findings, along with reduced postoperative cardiac troponin levels, have been replicated in other studies [29, 30]. Meanwhile, other studies comparing warm blood and cold crystalloid hyperkalemic cardioplegia do not show significant differences with respect to perioperative myocardial infarction and low cardiac output syndrome [31].
In general, administration of hyperkalemic cardioplegic solution can be done in either retrograde or anterograde fashion. Prior to both, IV heparin is administered, and the patient’s core body temperature is lowered to hypothermic levels, after which the aortic cross-clamp is placed and cardiopulmonary bypass is initiated [7]. Anterograde cardioplegia refers to delivering cardioplegic solution through a cannula inserted just proximal to the aortic cross-clamp. From there, the solution can flow into the left and right coronary arteries that supply the myocardium [32]. With anterograde cardioplegia, arrest usually occurs within 30 to 60 seconds. Retrograde cardioplegia may be considered in patients with complications such as severe coronary artery damage (e.g. severe stenosis) or aortic valve damage. Unlike anterograde administration, in retrograde administration the cardioplegia catheter is inserted into the coronary sinus from the right atrium, and solution is injected at a lower pressure (given the lower tolerance of the coronary sinus walls to turbulent flow) to avoid coronary sinus perforation [32].
Under physiological circumstances, the cardiomyocyte resting membrane potential is largely determined by two key factors: action of the sodium-potassium ATPase, and the high resting permeability of cardiomyocyte cell membranes to potassium [33]. First, the sodium-potassium ATPase hydrolyzes ATP to continuously pump potassium into the cell and sodium out of the cell, with a relative ratio of 3Na out/2 K in per molecule of ATP. Because it is the primary ion pump active while the cell is at rest, the sodium-potassium ATPase plays a critical role in generating the characteristic sodium and potassium electrochemical gradients across the cardiomyocyte cell membrane (high potassium and low sodium inside the cell relative to out). Second, at rest the cardiomyocyte cell membrane is most permeable to potassium while being relatively impermeable to other ions. This results in a resting membrane potential for cardiomyocytes that is close to the Nernst equilibrium potential for potassium, roughly −85 to -90 mV.
During cardiac muscle contraction, sinoatrial node stimulation induces a transient increase in the resting membrane potential of cardiomyocytes, which in turn opens voltage-gated sodium channels once the membrane potential surmounts -65 mV. Due to the high inward ion driving force on sodium (based on the considerable difference between the Nernst potential for sodium and the resting membrane potential), sodium ions flow through the sodium channels into the cardiomyocyte and further depolarize the cell until it reaches about 20 mV. At this point, sodium channels inactivate and L-type voltage gated calcium channels take over the maintenance of the action potential, allowing influx of calcium ions and producing the classic plateau depolarization of cardiac ventricular action potentials. Eventually, as calcium channels close and membrane potential begins to dip, delayed rectifier potassium channels open and restore membrane potential to the resting state. By this point, enough calcium has entered the cardiomyocyte to promote calcium-induced calcium release from intracellular calcium stores in the cardiomyocyte sarcoplasmic reticula, allowing muscle contraction to occur.
Extracellular hyperkalemia is the core principle underpinning most warm blood and cold crystalloid cardioplegic solutions. Essentially, administration of hyperkalemic solution takes advantage of the pivotal role of the potassium electrochemical gradient in determining cardiomyocyte resting membrane potential in order to elevate the resting membrane potential to a less negative value than typical baseline level. For example, physiologic extracellular potassium levels are often in the range of 3.5–5 mM, producing a resting membrane potential around -85 mV. During cardiac surgery involving cardioplegia, hyperkalemic solutions often raise extracellular potassium to the range of 10-40 mM (often midway in this range, around the 25 mM level), elevating cardiomyocyte resting membrane potentials to anywhere between −65 to -40 mV [34]. Arresting cardiomyocytes at this new range of elevated membrane potentials promotes fast sodium channel inactivation, thereby blocking myocardial action potential conduction. It also blocks repolarization, which is why hyperkalemic cardioplegia induces what is called “depolarized arrest.” Finally, it is important to note that cardioplegic arrest also significantly reduces cardiomyocyte oxygen consumption in a manner reminiscent of how severe ischemia depletes cellular ATP reserves [33].
Despite its clinical usefulness in reversibly arresting the heart during cardiac surgery, sustained depolarized hyperkalemic cardioplegia is not without some negative perioperative consequences. First, while most voltage-gated “fast” sodium channels are inactivated at membrane potentials above -50 mV (a frequent target cardiomyocyte membrane potential for potassium cardioplegia), resulting in generally poor membrane sodium conductance, not
Similarly, ATP depletion and reduced myocardial oxygen consumption during hyperkalemic cardioplegia leads to myocardial ischemia. Ischemia forces myocardial cells to resort to anaerobic glycolysis for energy production, which generates lactate as a byproduct. Increasing lactate levels in cardiomyocytes produces a metabolic acidosis and promotes increased activity of the H+/Na antiporter to move protons out of the cells at the expense of bringing in more sodium [36]. Finally, the combination of high extracellular potassium, intracellular acidosis, and hypothermia due to cold cardioplegic solution inhibits action of the sodium-potassium ATPase, which further facilitates the buildup of intracellular sodium [34].
Note that -50 mV is also in the vicinity of the reversal potential of the sodium/calcium exchanger [37, 38]. Under normal circumstances, the sodium/calcium exchanger moves 3 Na in for every 1 Ca moved out of the cell. However, due to the sodium window current and depolarized arrest in hyperkalemic cardioplegia, the sodium/calcium exchanger eventually begins operating in reverse, moving 3 Na out for every 1 Ca in, producing a so-called calcium “window current.” Moreover, if the hyperkalemic cardioplegic solution holds cardiomyocyte membrane potentials above -50 mV, e.g. at around -40 mV, then voltage-gated slow calcium channels will begin to activate, causing further calcium influx [39]. All of these reasons help explain why many hyperkalemic cardioplegic solutions in clinical practice are also hypocalcemic relative to physiological extracellular calcium levels (or contain calcium channel blockers), to attempt to mitigate the severity of myocardial calcium loading [34].
Cytosolic calcium loading during hyperkalemic cardioplegia contributes to cardiomyocyte damage through several mechanisms [40]. Enhanced activation of calcium dependent proteases and lipases (e.g. phospholipases) contributes to plasma membrane phospholipid degradation, ultrastructural changes in the sarcolemmal membrane, and accumulation of pathological catabolic byproducts. Enhanced activation of calcium-dependent ATPases accelerates depletion of intracellular ATP stores that have already been lowered following hypothermic arrest. This further perturbs cardiomyocyte sarcolemmal calcium transport channels that rely on ATP to maintain intracellular calcium homeostasis. Moreover, hypoxia during hyperkalemic cardioplegia increases mitochondrial calcium uptake via reversal of mitochondrial sodium/calcium exchangers in a manner akin to reversal of cardiomyocyte cell membrane sodium/calcium exchangers [41].
Mitochondria can only endure so much calcium uptake before the onset of irreversible damage. Indeed, following reperfusion after hyperkalemic cardioplegia arrest, mitochondria exhibit increased oxygen free radical production and reduced superoxide dismutase activity, indicative of heightened oxidative stress [41]. Sustained oxidative stress can lead to opening of mitochondrial permeability transition pores (MPTP), which promote mitochondrial swelling and mitochondrial membrane rupture. An assortment of mitochondrial enyzmes and molecules, such as cytochrome c, leak out into the cytosol through the MPTPs [41]. Cytochrome c is implicated in intrinsic apoptotic pathways through activation of cytosolic caspases and subsequent formation of myocardial apoptosomes [41].
Myocardial apoptosis during hyperkalemic cardioplegic ischemia–reperfusion merits further consideration for two major reasons. First, several studies have shown associations between hyperkalemic cardioplegic arrest and endothelial cell and cardiomyocyte apoptosis [42, 43, 44]. Second, several independent pathways of myocardial cell injury converge on apoptosis. Examples include mitochondrial oxidative stress and activation of an intrinsic apoptotic pathway (introduced earlier), or an extrinsic pathway driven by elevated humoral factors such as Fas or TNF-alpha acting on pro-apoptosis cell membrane receptors [44, 45]. Both intrinsic and extrinsic pathways converge upon a similar final common pathway that is chiefly regulated by two key protein groups: the Bcl-2 and cysteine protease caspase families [46, 47].
Within the Bcl-2 family, two proteins are particularly significant: Bcl-2 itself, and Bad. The former is anti-apoptotic while the latter is pro-apoptotic. Phosphorylation inhibits Bad, blocking it from inactivating Bcl-2 [48]. Farther downstream in apoptotic signaling, cleavage of caspase 3 and poly ADP-ribose polymerase (PARP) is essential for ensuring final progression towards apoptosis. Meanwhile, apoptosis may also proceed via a caspase-independent pathway involving release of the mitochondrial flavoprotein apoptosis-inducing factor (AIF) from the mitochondria into the cytosol through MPTPs [49, 50].
A possible framework for understanding myocardial apoptosis after hyperkalemic CPB is as follows [48]. Activation of the intrinsic (mitochondrial) pathway leads to increased Bad activation/decreased Bcl-2 activation, which initiates the caspase cascade. Activation of the extrinsic pathway bypasses Bcl-2/Bad to directly activate the caspase cascade. As more and more caspases become activated, eventually terminal caspases, such as caspase 3, will be cleaved, leading to PARP cleavage. By this point, apoptosis has been irreversibly induced; DNA fragmentation and cell death quickly follow. In contrast, AIF translocation from the mitochondria to the cytosol may directly activate downstream/terminal caspases, bypassing initial/intermediary constituents of the caspase cascade.
Studies have shown that caspase 3 cleavage and Bcl-2/Bad phosphorylation are significantly increased in myocardial tissue following hyperkalemic cold-blood cardioplegia and reperfusion, even as total protein levels do not change [48]. Meanwhile, myocardial AIF levels increase slightly, accompanied by a trend towards nuclear translocation, consistent with a model of AIF induced chromatin condensation and DNA fragmentation as a mechanism of cell injury [48]. Note that both pro-apoptotic (e.g. caspase 3) and anti-apoptotic (e.g. phosphorylated Bad) mediators are activated—nevertheless, given the downstream terminal position of caspase 3, the overall balance in myocardial cells appears to be tipped in favor of pro-apoptotic signaling.
Different formulations of hyperkalemic cardioplegia (e.g. cold crystalloid, warm blood, etc.) may exhibit differing degrees of myocardial protection and prevention of apoptosis. Indeed, evidence exists suggesting that cold blood hyperkalemic cardioplegia is superior to warm blood, warm crystalloid, and cold crystalloid cardioplegia, in terms of increased Bad phosphorylation and decreased caspase 3 activation [51]. Taken together, this combination of events appears to result in less apoptosis. In addition, these effects are associated with improved left ventricular function following cardioplegic arrest. However, this is not a universal finding in the literature. More work must be done to verify these conclusions and confirm if there truly is a definitive benefit to any one technique of hyperkalemic cardioplegia with respect to prevention of apoptosis.
An extensive body of research has established that hyperkalemic solutions induce significant vasoconstriction when experimentally applied to coronary artery and aortic ring preparations [2]. Thus, it is no surprise that hyperkalemic cardioplegia induces significant functional changes to the microcirculation, especially the coronary circulation [52]. For example, a sizeable number of patients undergoing hyperkalemic cardioplegia experience coronary artery spasm [52].
Potassium can influence coronary vasoconstriction in several ways. Holding coronary vascular smooth muscle membrane potentials at sustained depolarization during hyperkalemic cardioplegia increases the likelihood of generating contractions [53]. Potassium may also act indirectly to cause vasospasm through action on the coronary endothelium. Indeed, endothelial vasoconstrictive and vasorelaxant factors govern homeostatic regulation of coronary vasomotor tone. These factors influence vascular smooth muscle through modulation of various cell membrane potassium channels, including calcium-activated potassium channels and ATP-activated potassium channels [54, 55]. Important endothelial-derived relaxing factors include nitric oxide, endothelial-derived hyperpolarizing factor (EDHF), and cyclooxygenase enzymes. Important endothelial-derived constricting factors include endothelin-1 and thromboxane A2.
Porcine models of hyperkalemic cardioplegia showed that hyperkalemia significantly attenuated EDHF-mediated relaxation in coronary artery preparations [56, 57]. Moreover, hyperkalemic vasoconstriction has also been linked with impaired nitric oxide release [58] and impaired acetylcholine-dependent vascular relaxation [59, 60]. Potential mechanisms at play may involve potassium-induced inhibition of G protein and non-G protein signal transduction pathways, increased reactive oxygen and nitrogen species generation, decreased activity of endothelial nitric oxide synthase, and increased arachidonic acid metabolism [2]. Curiously, hyperkalemic cardioplegia has also been associated with decreased responsiveness of human coronary arterioles to the endothelial vasoconstrictors endothelin-1 and thromboxane A2 [61, 62]. These findings testify to the complexity of mechanisms underpinning coronary vasomotor dysfunction following hyperkalemic cardioplegia, most of which remain to be elaborated.
Despite its cardioprotective effects, hyperkalemic cardioplegia-reperfusion can exert detrimental effects on the myocardial and coronary endothelium, promoting endothelial dysfunction [63, 64]. One aspect of endothelial dysfunction—production of various endothelium-derived relaxing and contracting factors—was discussed earlier due to its relevance in coronary vasospasm. Other important features of endothelial dysfunction during hyperkalemic cardioplegic arrest include endothelial injury, inflammation, reactive oxygen species production, coagulation cascade dysfunction, and endothelial tight junction degradation [52, 65, 66, 67]. All these adverse effects may occur with potassium levels as low as 10 mM, well within the realm of most hyperkalemic cardioplegic solutions [2]. To elaborate, potassium concentrations of 30 mM in St. Thomas and Custodiol cardioplegic solutions proved considerably more damaging to the vascular endothelium than potassium concentrations of 20 mM, demonstrating the importance of strict potassium limits in hyperkalemic cardioplegic solutions [6].
A variety of structural changes to the vascular endothelium have been observed in experimental models of hyperkalemic cardioplegia. Key examples include endothelial intracellular vacuolization, membrane blebbing, adventitial fibrosis, and overall reduced viability [68, 69]. Furthermore, hyperkalemic cardioplegia promotes increased lipid uptake and cholesterol deposition in vascular intimae in primate models of post-graft venous atherosclerosis [70]. In addition, compromised endothelial adherens junctions during hyperkalemic cardioplegia mediate increased vascular permeability and tissue edema [67]. Indeed, animal models of cardioplegia/CPB show increased post-procedure VE cadherin, beta-catenin, and gamma-catenin fragments, all of which are important structural components of adherens junctions [71]. In humans, increased endothelial cadherin phosphorylation, and decreased overall beta-catenin levels, have been observed in atrial tissue following hyperkalemic cardioplegia/CPB [72].
Details of specific mechanisms underlying these endothelial disturbances remain largely unclear; however, many possibilities exist. For example, it is generally agreed that depolarization induced by hyperkalemic cardioplegia is a critical initiating step of the underlying pathophysiology [2]. Endothelial depolarization increases activation of neutrophils, inflammation, voltage sensitive NAPDH oxidases, and platelets [62, 63, 73, 74]. Inflammation and neutrophil activation often reinforce each other, as pro-inflammatory cytokines like IL-1, IL-6, and TNF-alpha further stimulate endothelial changes that promote neutrophil extravasation. NADPH oxidase catalyzes formation of important reactive oxygen species such as superoxide anions, which if left unchecked are severely cytotoxic. The amount of superoxide production during hyperkalemic cardioplegia has been linked to the extent of endothelial depolarization and translocation of the small G protein Rac from the cytosol to plasma membrane [75].
With respect to coagulation, potassium depolarization appears to have a direct stimulatory effect via enhancing ADP and collagen-induced platelet aggregation, along with an indirect effect through increased superoxide production [76, 77]. The latter appears to act through inhibition of endothelial NTPDases [78]. Membrane hyperpolarization reverses all these actions.
When left unchecked, sustained myocardial dysfunction following hyperkalemic cardioplegia-reperfusion may lead to myocardial stunning, a form of postoperative left ventricular dysfunction [1]. Myocardial stunning often manifests as markedly reduced cardiac output without obvious evidence of infarction or injury (e.g. no signs of elevated troponin or CKMB in blood). Like myocardial apoptosis, myocardial stunning represents another final common pathway of convergence for several different pathophysiological mechanisms of hyperkalemic cardioplegia, chiefly dysregulated free radical production, coagulation imbalances, and excessive catecholamine release [1]. However, unlike with apoptosis, in this scenario injury results from abnormal myocardial contractility as opposed to myocardial cell death.
Postoperative imbalances in a variety of different electrolytes, including calcium, magnesium, potassium, and phosphate, have been observed following cardioplegia/CPB. Here, we will focus on potassium, beginning with hypokalemia. Hypokalemia can be defined as a serum potassium level that is less than 3.5 mEq/L [78]. Postoperative hypokalemia is a common finding after cardiac surgery involving hyperkalemic cardioplegia and CPB, and manifests almost immediately after the patient is weaned off the bypass circuitry [79]. Hence IV potassium supplementation during cardioplegia is extremely important to mitigate against the most severe manifestations [80].
However, even with electrolyte supplementation in the operating room, CPB poses a high risk of post-procedure electrolyte depletion [81]. The pivotal role of potassium in normal cardiac contractility means that disturbances in potassium homeostasis significantly increase the risk of arrythmias and, in severe cases, sudden cardiac arrest. Indeed, arrythmias, especially atrial tachyarrhythmias (e.g. atrial fibrillation, atrial flutter) and, less frequently, ventricular arrhythmias, are a major source of morbidity and mortality following cardiac surgery [82, 83].
Specific mechanisms underpinning this phenomenon remain largely unclear; however, a variety of possibilities exist [78]. For example, poor oral intake of potassium-rich foods prior to cardiac surgery may contribute to enhanced depletion during surgery. In addition, prolonged preoperative use of digoxin, along with thiazide and loop diuretics may play a role. These agents may cause hypomagnesemia (low magnesium levels), which can contribute to extracellular potassium depletion. Under normal circumstances, intracellular magnesium binds to and blocks the pores of renal outer medullary potassium (ROMK) channels in the distal nephron, preventing outward flux of potassium into the renal tubular network [78]. Thus hypomagnesemia may remove this physiologic limiter, leading to increased renal clearance of potassium.
A hyperactive aldosterone response to stress may also be implicated, particularly in the context of congestive heart failure [78, 80]. Moreover, increased catecholamine (norepinephrine and epinephrine) release during cardiopulmonary bypass may facilitate hypokalemia given the influence of catecholamines on plasma potassium [84, 85]. Animal models have shown that elevated catecholamine levels can produce first, a transient hyperkalemia due to activation of hepatic calcium-dependent potassium channels by alpha adrenergic stimulation and second, a sustained hypokalemia by stimulation of skeletal muscle Na-K ATPase [86]. Such studies need to be replicated in humans undergoing cardiopulmonary bypass-hyperkalemic cardioplegia in order to verify the applicability of these putative mechanisms.
Because glucose is often given during cardioplegia, insulin may also be administered to minimize the chances of hyperglycemia. However, given that insulin acts as a regulator of potassium distribution between intracellular and extracellular fluid compartments by stimulating Na-K ATPase activity, it is possible that insulin administration during and after cardioplegia may contribute to potassium depletion [87]. Next, given that many cardioplegic solutions in current practice are cold hyperkalemic solutions, any potential impact of hypothermia on potassium homeostasis during cardiac surgery cannot be ignored. As with insulin, hypothermia has been linked to an intracellular shift of potassium away from the extracellular space through as-yet unelaborated mechanisms [88]. Finally, the CPB circuit itself has been shown to significantly dilute overall blood plasma protein concentrations, which may also affect plasma ion homeostasis [89].
In general, treatment of postoperative hypokalemia largely centers on administration of potassium chloride (KCl) solution to elevate extracellular potassium concentrations to physiologic levels. Indeed, in the case of pediatric cardiac ICU patients for whom enteral potassium supplementation is contraindicated, IV KCl administration is one of the only available tools for correcting hypokalemia [90]. For most patients, this proves sufficient to correct the imbalance and stave off the development of hypokalemia-induced arrhythmias. However, in a small minority, external KCl solution does not reverse the hypokalemia—and so in these patients, the chances of arrhythmias increase exponentially.
Although hypokalemia is the most common potassium electrolyte abnormality following hyperkalemic cardioplegia-CPB, postoperative hyperkalemia may occur under certain, albeit rarer, circumstances. In general, postoperative hyperkalemia is a concern mainly in patients with renal failure undergoing CPB, most likely due to renal tubular dysfunction [91]. Severe hyperkalemia may be treated with IV calcium gluconate, an insulin-dextrose regimen, and diuretics [92]. If a patient has end-stage renal disease, dialysis may be the best option to treat hyperkalemia, along with IV calcium to stabilize the myocardium and IV insulin to shift potassium into cells [93].
Hyperkalemic cardioplegia is by far the most widely used method of cardioplegia in current clinical practice. However, because of the numerous perioperative repercussions of hyperkalemic cardioplegia, a variety of attempts have been made to explore alternative approaches. Given that many adverse effects of hyperkalemic cardioplegia stem from its induction of depolarized arrest, one popular avenue of investigation has been the possibility of hyperpolarized arrest. Hyperpolarization is the natural resting state of cardiomyocytes, so in theory, arresting the heart at its baseline hyperpolarized state may better preserve physiological integrity. In isolated animal heart models, hyperpolarized arrest has been achieved via pharmacologic activation of ATP-sensitive potassium channels [94, 95]. Following reperfusion, this form of hyperpolarized arrest appeared to lead to improved postischemic functional recovery when compared to hearts protected with depolarized arrest.
Meanwhile, so-called “polarized arrest” has been proposed as another alternative to hyperkalemic cardioplegia. The core principle behind this concept is administration of sodium channel blockers, such as procaine in humans or tetrodotoxin in animal models [96]. Sodium channel blockade prevents depolarization-induced activation of calcium currents, which normally carry out the bulk of the cardiomyocyte action potential. Overall, in animal models, tetrodotoxin-induced polarized arrest reduces metabolic demands during ischemia, including myocardial oxygen consumption, more so than hyperkalemic cardioplegia [96]. Furthermore, polarized arrest may produce less significant postoperative ionic imbalances, with further protection provided by coincident administration of sodium/potassium/chloride transporter and sodium/proton exchanger inhibitors [96]. Nonetheless, more work needs to be done to verify the broader clinical applicability of these alternatives to hyperkalemic cardioplegia.
By taking advantage of the pivotal role of potassium in cardiomyocyte physiology, hyperkalemic cardioplegia has become an integral tool for cardiac surgery. From the early days of Dennis Melrose’s simple potassium citrate solution to complex modern-day formulations such as the Del Nido and Buckberg media, approaches to developing and administering hyperkalemic cardioplegic solutions have evolved considerably, with a continuing focus on developing the most cardioprotective and least damaging solutions possible. While initial approaches to hyperkalemic cardioplegia revolved around hypothermic solutions, normothermic/“warm” solutions, along with blood as opposed to crystalloid-based solutions, are gaining momentum as potential alternatives to mitigate adverse perioperative consequences of cold hyperkalemic cardioplegia. Some of those consequences include myocardial calcium loading, myocardial apoptosis, coronary vasomotor dysfunction, myocardial endothelial dysfunction, and myocardial stunning. With any form of hyperkalemic cardioplegia, plasma potassium abnormalities following reperfusion, mainly postoperative hypokalemia, remain a persistent clinical concern. And while most patients respond well to IV KCl supplementation, some do not and proceed to develop fatal arrythmias, underscoring the need for further research to understand the mechanisms at play and develop new treatments. In the future, it is possible that other approaches such as hyperpolarized or polarized arrest may challenge the widespread use of depolarized hyperkalemic cardioplegic arrest. Nevertheless, for the time being, hyperkalemic cardioplegia remains dominant in cardiac surgery, and will likely continue to be so for some time to come.
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The authors declare no conflicts of interest.
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We characterized the optical wireless communication channel through the channel measurements and present different models for the OWC link performance evaluations. In addition, we present some technologies for the OWC performance enhancement in order to address the last-mile transmission bottleneck of the system efficiently. The technologies can be of great help in alleviating the stringent requirement by the cloud radio access network (C-RAN) backhaul/fronthaul as well as in the evolution toward an efficient backhaul/fronthaul for the 5G network. Furthermore, we present a proof-of-concept experiment in order to demonstrate and evaluate high capacity/flexible coherent PON and OWC links for different network configurations in the terrestrial links. To achieve this, we employ advanced modulation format and digital signal processing (DSP) techniques in the offline and real-time mode of the operation. 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Further, the improved dual circularly polarized (CP) omnidirectional antenna based on slot array in coaxial cylinder structure is presented too, and two ports are assigned in its two side as left hand circularly polarized (LHCP) port and right hand circularly polarized (RHCP) port, respectively. 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