1 The liver is one of the most vital organs and is highly prone to damage during CABG. Dilutional anemia and hemodynamic changes can affect tissue
oxygenation, and most studies state that a minimum hematocrit level of 22% is necessary for the on-pump technique.2 Suitable perfusion and tissue oxygenation is considerably effective in the function of organs before, during, and after surgery.3 During cardiopulmonary bypass Inhibitors,research,lifescience,medical (CPB), the possibility of liver damage increases owing to the-non pulsatile perfusion, low-flow state, free radicals formation, and increased levels of catecholamines.4 Some studies have reported that CPB usually induces mild hepatocellular damage, whereas off-pump coronary bypass decreases the possibility of this damage.5 However, reports on CPB are conflicting because hypothermia decreases the oxygen demand of the splanchnic organs and, thus, hepatocellular oxygenation Inhibitors,research,lifescience,medical is preserved
better during hypothermic CPB.6 Comparison between pulsatile and non-pulsatile flows during CPB shows no significant difference between the two flows during CPB.7 Moreover, comparison between CABG with or without CPB demonstrates that the liver metabolic function is not changed by the type of coronary bypass selleck inhibitor surgery but that hepatic ischemia is detected after cardiac surgery with CPB, which is usually marked with an increase in Inhibitors,research,lifescience,medical alanine aminotransferase (ALT) enzyme levels.8 Given the inconsistency in the studies on the effects of CPB on the liver function test post on-pump CABG, we aimed to evaluate the impact of CPB and other factors that may aggravate Inhibitors,research,lifescience,medical changes on the liver function test after on-pump cardiac surgery. Patients and Methods In this quasi-experimental clinical trial, which was done during 2011, after obtaining approval from the Ethics Committee and written informed consent from the patients, 146 out of 190 patients who referred to hospitals affiliated to Shiraz University of Medical Sciences,
southern Iran, for elective CABG were recruited. The sample size was calculated to be 142 patients considering α of 0.05, power of 80%, and standard deviation (SD) of 9 Inhibitors,research,lifescience,medical (using the power static software calculator [SSC]). Patients who had simultaneous cardiac valvular surgery, those with hemolytic disorders, and those Edoxaban with abnormal liver function tests prior to surgery or those with a history of fatty liver or chronic liver disease were excluded from the study. The patients’ data including age, sex, Body Surface Area, hematocrit level, direct and indirect bilirubin levels, hepatic enzymes (aspartate aminotransferase [AST], ALT, and alkaline phosphatase [ALP]), serum creatinine, ejection fraction, history of cardiovascular and cerebral diseases, and history of diabetes mellitus were recorded in a specific form. Following anesthesia induction using Midazolam, Sufentanil, Na-Thiopental, and Pancuronium, Morphine was administered for the patients.