Evaluation of Serum C-Reactive Protein Levels Before and After Cardiopulmonary Bypass for Cardiac Surgery

With the new arrivals in open heart surgery and cardiopulmonary bypass, the present study was undertaken to monitor the extent of acute inflammatory response to cardiopulmonary bypass by using serum CRP as an indicator and correlating this with the early morbidity and mortality in patients undergoing cardiopulmonary bypass for cardiac surgery. 25 patients, aged 10-40 years of NYHA Class I, II, III scheduled for open heart surgeries with the use of cardiopulmonary bypass were included in the study in our study. The serum CRP levels were measured at 6 hours and 24 hours after weaning from cardiopulmonary bypass. The results were analysed using the unpaired t-test to find out if the increase in serum CRP levels and patient morbidity were statistically significant. There were no significant differences regarding anesthetic premedication, induction and maintenance drugs and intraoperative hemodynamics between patients with duration of cardiopulmonary bypass 90 min. & those with the duration of >90 minutes. However there was a change in the level of CRP between these two groups. Increase in the levels of serum CRP at 6 hours and 24 hours after weaning from cardiopulmonary bypass was noted in patients who developed morbidly and mortality post procedure. All the above mentioned patients with complications had undergone cardiopulmonary bypass of duration >90 min. In our study, Aprotinin was used in 4 patients and these patients had reduced mean CRP as compared to the controls. Elevated serum concentration of CRP is an unequivocal evidence of an active tissue damage process. CRP levels invariably rise after major surgery but fall to normal within 7-10 days. Absence of this fall is indicative of possible septic or inflammatory postoperative complications. Further, by serial measurements important information can be obtained on the resolution or continuation of the inflammatory process. Thus, we conclude that serum CRP levels can be used to monitor the extent of inflammatory response induced by cardiopulmonary bypass. The duration of cardiopulmonary bypass directly influences the inflammation and damage caused which is suggested by patient morbidity and mortality in the postoperative period.