Aim: The effects of cardiac surgery and cardiopulmonary bypass on postoperative liver function tests and hyperbilirubinemia in adult patients undergoing open heart surgery were studied, and related literature was reviewed and compared with our results.
Materials and Methods: Between January 2013 and March 2013, forty adult patients who undergone open heart surgery were included in this study. Patients were prospectively evaluated in regard of the alterations in liver function tests, the risk factors that effects these alterations; their effects on morbidity and mortality after cardiopulmonary bypass were evaluated and were compared with recent literature results. Patients preoperative and postoperative 0, 1, 2, 7 and 14th day liver function tests and bilirubin levels were measured.
Results: Blood total protein, albumin, total cholesterol, ALP levels were fallen remarkably on postoperative day 1, followed with gradual increase ultimately reaching preoperative levels, and these alterations were statistically significant. The total bilirubin, AST, ALT, LDH, GGT, INR levels were elevated in the early postoperative period, and fell to normal levels later on. All increases of the enzymes were statistically significant except ALT. In our study, only 7 patients displayed hyperbilirubinemia. When patients with hyperbilirubinemia were compared with patients who did not have hyperbilirubinemia, preoperative albumin and CK levels were found to be risk factors for hyperbilirubinemia.
Conclusion: By studying the effects of heart and cardiopulmonary bypass surgery on the liver and the probable risk factors, we believe that by detecting the patients with high risk of hepatic failure required measures should be taken preoperatively, perioperative patient care quality improved and any complication can be fixed appropriately. To understand the reasons and prevention of perioperative hepatic failure, we think that the studies should be performed with larger patient groups with longer periods.
Key words: Liver Function Tests; Hyperbilirubinemia; Open Heart Surgery.
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