Does cardiopulmonary bypass alter routine laboratory values in patients undergoing elective cardiac surgery?
Cardiopulmonary bypass during elective cardiac surgery is associated with significant alterations in hematologic, electrolytic, and hepatic laboratory parameters, including decreased hemoglobin and platelets, and increased lactate and AST.
Cardiac surgeries have become a cornerstone in the treatment of various cardiac issues, including congenital heart disease, ischemic heart disease, and severe valvular lesions.Apart from off-pump cardiac surgeries, cardiopulmonary bypass is usually instituted to replace cardiopulmonary functions; meanwhile, the heart and lungs are set to a standstill during the procedure 1. Whena patient undergoes cardiopulmonary bypass, blood is drawn from the superior vena cava, inferior vena cava, and right atrium and returned to the heart and lung machine for the release of oxygen and carbon dioxide before passing through the blood pump to resume blood circulation 2.When the internal environment of the body is exposed to foreign objects like oxygenators and ducts Abstract Introduction: During cardiopulmonary bypass, numerous organ functions may be negatively impacted, either directly or indirectly.Organ ischemia-reperfusion injury and the inflammatory stress response can both exacerbate existing organ damage, resulting in a systemic, diffuse, multiorgan inflammatory stress response. Aim of the study:To highlight the effects of CPB on different laboratory values by performing a secondary analysis of available data from previous studies. Subjects and Methods:The entries for this study were originally collected for an observational study to assess the predictive value of lung ultrasound scores in predicting postoperative intensive care length of stay.191 patients above 18 years and scheduled for elective cardiac surgery for valve replacement or on-pump Coronary Artery Bypass Grafting (CABG) via median sternotomy were included. Results: A noted decrease in platelet count (297.91±80.77versus 233.74±79.56),hemoglobin level (13.4±1.38 versus 10.9±1.04), and serum potassium level (4.14±0.53versus 3.51±0.45).An increase in INR (1.13±0.1 versus 1.27±0.15),serum lactate (0.57±0.34 versus 4.88±3.03),and serum AST (27.68±13.43versus 41.37±21.08)was also seen.Conclusions: After cardiopulmonary bypass, platelet count, hemoglobin level, and serum potassium tend to decrease, whereas INR, AST, and serum lactate tend to increase.
Boules et al. (2023) studied this question.
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