Serum carnitine profile changes after open heart surgery in children with CHDs

L-carnitine is essential for myocardial metabolism, and its depletion may compromise heart function. We conducted a prospective observational study to assess serum carnitine profiles in 26 children under 36 months of age undergoing elective open-heart surgery with cardiopulmonary bypass. Measurements included free carnitine, acylcarnitine, and the acylcarnitine-to-free carnitine ratio, recorded preoperatively and at multiple postoperative time points up to 24 hours. We observed a significant postoperative decline in free carnitine and an increase in the acylcarnitine-to-free carnitine ratio, both of which correlated with cardiopulmonary bypass duration. These results highlight a perioperative disturbance in carnitine metabolism, suggesting potential relevance for postoperative cardiac recovery.