Elevated Liver Enzyme after Cardiac Surgery by on Pump Method

Bibliographic Details
Title: Elevated Liver Enzyme after Cardiac Surgery by on Pump Method
Authors: Ali Jabbari, Shabnam Tabasi, Mansour Deylami
Source: Archives of Anesthesia and Critical Care, Vol 11, Iss 2 (2024)
Publisher Information: Tehran University of Medical Sciences, 2024.
Publication Year: 2024
Collection: LCC:Anesthesiology
LCC:Medical emergencies. Critical care. Intensive care. First aid
Subject Terms: liver enzyme, cardiac surgery, cardiopulmonary bypass, cytokines, ischemia-reperfusion injury, Anesthesiology, RD78.3-87.3, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
More Details: Elevated liver enzymes after on-pump cardiac surgery indicate potential recovery delays, complications, and long-term damage. The heart-lung machine can cause liver injury, leading to longer hospital stays and risks from systemic inflammatory response syndrome (SIRS). Factors like mechanical stress and ischemia-reperfusion injury release inflammatory mediators that harm liver cells. Key markers of liver injury include alanine aminotransferase (ALT) and aspartate aminotransferase (AST), with ALT being more specific. Increased alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) may suggest biliary problems. Ischemia-reperfusion injury occurs when blood flow is interrupted, causing oxidative stress that affects liver health. Cannulating the vena cavae can worsen liver congestion and damage, especially if improperly placed, risking ischemic injury and liver function impairment. Surgeons should consider pre-existing liver conditions, as they can worsen cannulation effects. Cardiopulmonary bypass (CPB) can disrupt liver microcirculation, affecting oxygen and nutrient delivery. Mechanical hemolysis from the machine can release toxic substances that harm the liver. Anesthetics and antibiotics may also elevate liver enzymes. Risk factors include prolonged CPB times, existing liver issues, older age, obesity, diabetes, kidney dysfunction, and chronic alcohol use. To manage liver enzymes, optimizing CPB techniques and monitoring liver function post-surgery are crucial. Understanding the inflammatory response linked to on-pump techniques can enhance patient care and outcomes.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2423-5849
Relation: https://aacc.tums.ac.ir/index.php/aacc/article/view/1072; https://doaj.org/toc/2423-5849
DOI: 10.18502/aacc.v11i2.17976
Access URL: https://doaj.org/article/265fc39fc5214d06807e1fc0207071c3
Accession Number: edsdoj.265fc39fc5214d06807e1fc0207071c3
Database: Directory of Open Access Journals
More Details
ISSN:24235849
DOI:10.18502/aacc.v11i2.17976
Published in:Archives of Anesthesia and Critical Care
Language:English