Acute Hepatic Injury Following Cardiac Surgery: Retrospective Observational Study Kardiyak Cerrahi Sonrası Akut Karaciğer Hasarı: Retrospektif Gözlemsel Çalışma
Anestezi Dergisi, cilt.31, sa.4, ss.283-290, 2023 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 31 Sayı: 4
- Basım Tarihi: 2023
- Doi Numarası: 10.54875/jarss.2023.50133
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, Academic Search Premier, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.283-290
- Anahtar Kelimeler: Acute hepatic injury, cardiac surgery, cardiopulmonary bypass
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Cardiopulmonary bypass (CPB) and cardiac surgery can have multiple systemic effects on the patient. This retrospective study aims to investigate the effect of this change on liver enzymes. Methods: Demographic data, comorbidities, preoperative and postoperative laboratory data, intraoperative cross-clamp and CPB duration, blood and blood product transfusions, and fluid balance of 390 patients who underwent on-pump coronary artery bypass grafting (CABG) were retrospectively reviewed. Patients with a twofold or greater increase in postoperative alanine transaminase were considered to have an acute hepatic injury (Group AHI). Multivariate logistic regression was performed to find independent predictors for AHI. Results: Body mass index, hyperlipidemia, and diabetic patients were significantly higher in group AHI (p<0.05). Similarly, fresh frozen plasma (FFP) transfusion, platelet transfusion, and the need for insulin, dopamine, and adrenaline were observed to be higher in the AHI group in the intraoperative period (p<0.05).Cardiopulmonary bypass time was longer and total urine volume was less in Group AHI (p<0.05). The need for intraaortic balloon pump (IABP) and/or extracorporeal membrane oxygenation (ECMO) on weaning from the CPB pump was seen in more patients in Group AHI (p=0.021). According to the results of multivariate logistic regression analysis, it was determined that the risk of AHI is 2.27 (1.144-4.543, 95% CI, p=0.019) times higher in hyperlipidemic patients, 2.84 (1.077-7.494, 95% CI, p=0.35) times higher in patients who need intraoperative 3-4 units of FFP, and 4.37 (1.107-17.264, 95% CI, p=0.035) times higher in patients who need IABP and/or ECMO after CPB. Conclusion: There is a strong relationship between AHI after cardiac surgery and hyperplidemia, FFP transfusion, and the need for IABP and/or ECMO.