A study on serum enzymes after open heart surgery
Tsuboi, H.
Nihon Kyobu Geka Gakkai 33(8): 1129-1141
1985
ISSN/ISBN: 0369-4739 PMID: 4078369 Document Number: 251479
Serial changes of the serum enzymes, GOT, GPT, LDH, LDH1, CPK and CPK-MB before and after the cardiopulmonary bypass were evaluated in 85 patients undergoing open heart surgery. The following results were obtained: After cardiopulmonary bypass, GOT, LDH, LDH1, CPK and CPK-MB rose prominently. CPK-MB was the most specific and sensitive parameter of myocardial damage. It reached the highest value within 3 to 6 hours after cardiopulmonary bypass. Both total CPK-MB and peak CPK-MB were considered as the good indices of the myocardial damage. *VCPK-MB was useful as the index of myocardial damage, only when *VCPK-MB exceeded 25 mu/ml per hr. Peak CPK-MB, measurement of which was extremely easy, could be the index of myocardial damage as a substitute for total CPK-MB. Total CPK-MB and peak CPK-MB and peak CPK-MB did not always correlate with the level of postoperative cardiac function. Incidence of low cardiac output syndrome appeared to correlate with the high enzyme levels, such as GOT 160U, LDH 950U, LDH1 400U, CPK 1500 mu/ml and CPK-MB 230 mu/ml. Especially in the case that three or more of these enzyme exceeded those levels, there was a high possibility of developing LOS. Infants and children showed higher value of the all enzymes than adult before and after cardiopulmonary bypass, except GPT. It was thought that intermittent aortic cross clamping had strong ischemic influence to the cardiac muscle, and therefore the method of myocardial protection should be improved. Enzymes were good indices of the myocardial damage and useful for the management of the postoperative patients.