Abstract
Objective: In
cardiac surgery , the
lung , renal and neurological events are the most frequent
complications . Less common,
acute liver failure is a serious complication that adds high
morbidity ,
mortality , and
costs . Therefore, this
communication aimed to retrospectively evaluate five
patients who presented, in 2014, severe
acute liver failure in the immediate
postoperative period .
Methods: Retrospective
data analysis of
patients '
medical records that showed severe
liver failure has been computed in the
medical records of five
patients undergoing
cardiac surgery at the
Hospital da Faculdade de Medicina de Ribeirão Preto – USP in the immediate
postoperative period from February 1, 2014 to December 12, 2014. The study selected five
males patients , 60 to 67 years old,
cardiopulmonary bypass mean
time of 101.4 minutes (varying from 80 to 140 minutes),
who presented acute perioperative
liver failure .
Results: The five
patients showed an impressive increase of
blood transaminase (
serum alanine aminotransferase ), suggesting acute
hepatitis . The evolution of all
patients was catastrophic, with severe
hemodynamic effects and
death . Many studies suggest that systemic
hypotension is an important pathogenic factor for ischemic
hepatitis . However, our data and previous studies raise the possibility that other yet unknown factors other than
hypotension may be part of the pathophysiology of
cardiopulmonary bypass after ischemic
hepatitis (anticoagulation inadequate for the quality of
heparin and
protamine , etc.).
Conclusion: Currently, there are no conclusive studies on the prevention of perioperative
liver failure . More well-designed studies are needed on the introduction and evolution of
liver dysfunction after
cardiac surgery .