Hepatopathy and acute kidney injury Following Corrective Cardiac Surgery with cardiopulmonary bypass pump in Pediatric with Congenital Heart Defects.

Abstract

Background: Congenital heart defects (CHDs) are common anomalies in children. Cardiopulmonary bypass (CPB) is widely used in cardiac surgeries, but it is associated with complications. Liver and kidney injuries frequently occur during CPB. This study aimed to evaluate liver and kidney damage in pediatric patients with CHDs undergoing cardiac surgery with CPB.

Methods: This retrospective study examined 51 patients with CHDs who underwent cardiac surgery with CPB at Vali-Asr and Razi hospitals in Birjand, Iran. The study period spanned from 2013 to 2019. Patient information was extracted from hospital records and compiled into checklists, which included demographic data, disease severity, liver function tests, cardiac ejection fraction, and serum levels of hematocrit, direct and indirect bilirubin, albumin, total protein, and creatinine.

Results: Among the patients, 52.9% were male and 47.1% were female, with a mean age of 37 months. A total of 78.4% had cyanotic CHDs.After surgery, the levels of AST, ALT, and ALKP increased significantly (P < 0.001), while the levels of indirect bilirubin, albumin, and total protein decreased (P < 0.001). The cardiac ejection fraction also improved following surgery (P < 0.001). However, changes in creatinine and direct bilirubin were not significant. Notably, AST levels were markedly higher in deceased patients compared to survivors.

Conclusion: This study revealed significant alterations in liver enzyme levels in patients undergoing cardiac surgery using CPB, potentially indicating liver damage during the procedure. Furthermore, elevated postoperative AST levels were associated with a higher risk of mortality.