Some biochemical indices in monitoring myocardial ischemic arrest, reperfusion and recovery during open cardiac surgery procedures

ABSTRACT

The present study was conducted on 12 patients [8 males and 4 females] undergoing open cardiac surgery. Plasma lactate, serum total creatine phosphokinase [CPK] and its MB isoenzyme [CPK-MB] were measured in those patients at different stages of open cardiac surgery procedures [stage I up to stage VI]. Plasma-lactate revealed highest level in stage IV [reperfusion phase] which was significantly higher than stage I [before anaesthesia] and stage II [after crossclamp on- ischemic arrest]. Serum total CPK showed significant gradual increase from stage I up to stage IV and then decreased; while CPK-MB was significantly increased in stage V [24 hours after recovery] as compared to I and III. Both of them were significantly increased in stage IV as compared to stage III. The present study revealed also persistent rising of the meanvalues of plasma lactate, serum total CPK and CPK-MB up to one week following open cardiac surgery [stage VI], in patients with poor post operative myocardial function comparing to lower values among patients with good and fair results of myocardial function. The present data may confirm the degree of myocardial ischemic insult and reperfusion injury during open cardiac surgery. They can be used as biochemical monitoring indices for evaluation of myocardial haemodynamics and out come results of open cardiac surgery patients