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Evaluation of liver function tests after coronary artery bypass surgery (CABG)
Saeedeh Zakeri1, Hamidreza Vafaey2, Nadia Banihashem2
1Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
Caspian Journal of Internal Medicine
|March 8, 2021
Summary
Coronary artery bypass graft (CABG) surgery can impact liver function tests (LFTs), with longer pump and clamp times increasing risk. Monitoring for liver injury is crucial, especially after using an intra-aortic balloon pump (IABP).
Area of Science:
- Cardiovascular Surgery
- Hepatology
- Critical Care Medicine
Background:
- Coronary artery bypass graft (CABG) surgery can induce systemic effects impacting organ function, including the liver.
- Assessing liver function changes post-CABG is essential for patient management.
Purpose of the Study:
- To evaluate changes in liver function tests (LFTs) after on-pump CABG surgery.
- To identify risk factors associated with LFT alterations.
- To determine the incidence of acute liver injury following on-pump CABG.
Main Methods:
- A cohort of 385 patients undergoing on-pump CABG was analyzed.
- Preoperative and intraoperative data were collected to identify risk factors.
- Postoperative LFTs at 24, 48, 72 hours, and discharge were compared to baseline using univariate linear regression.
Main Results:
- Significant correlations were found between LFT changes and cardiopulmonary bypass time, aortic cross-clamp time, and intra-aortic balloon pump (IABP) use.
- A history of myocardial infarction was linked to elevated direct bilirubin in the initial 48 hours post-surgery.
- Preoperative left ventricular ejection fraction, smoking, and opium use correlated with postoperative AST changes. Acute ischemic liver injury occurred in 0.77% of patients.
Conclusions:
- Minimizing cardiopulmonary bypass and aortic cross-clamp times during CABG is recommended.
- Anticipate and monitor for potential liver injuries, particularly following IABP insertion, to ensure timely treatment.
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