Abstract

One of the most important gastrointestinal complications following cardiac surgery is hepatic dysfunction. This prospective study was evaluated the incidence and significance of liver dysfunction after open cardiac surgery. This study was conducted on 150 patients who were candidates for heart surgery. Liver tests including bilirubin (total and direct), alkaline phosphatase, AST, ALT were measured before the operation and on the first, third, and seventh postoperative days. Out of 150 patients, 80 were men (53.3) and 70 were women (46.7) with mean age of 62 +/- 12.5. Level of AST, ALT and bilirubin total has increased significantly after surgery (P<0.05). There were significant relationship between AST, ALT and alkaline phosphatase on first day after surgery and hypothermia less than 32 degrees C (P<0.05), blood transfusion more than 6 units (P<0.05), intraoperative hypotension (P <0.001), duration of the pump over 100 minutes (P < 0.001) and smoking (P<0.05). There was significant difference between two groups in length of ICU stay (7.14 +/- 9.17 days in patients with liver enzyme changes VS. 4.11 +/- 2.17 days in patients without liver enzyme changes, p-value<0. 05). Patients with changes in liver enzyme had a longer hospital stay (25.2 +/- 6.48 in patients with liver enzyme changes VS. 9.23 +/- 5.3 in patients without liver enzyme changes, p-value<0. 05). Four deaths occurred among patients with changes in liver enzyme level but there was no death in patients without changes in liver enzyme levels that this difference in mortality rate was statistically significant (<0.005). The results of this study showed that there is a significant relationship between and changes in liver enzymes and hypotension during the, hypothermia, the pump duration, blood transfusion, and the type of the pump.