BIOCHEMICAL CONSEQUENCES OF CARDIOPULMONARY BYPASS SURGERY IN CHILDREN

The changes in serum enzyme activities after successful and uncomplicated cardiopulmonary bypass (CPB) surgery in children are described. After maximum serum enzyme activities were attained, they thereafter declined steadily without any secondary peaks of activity, to be at or near normal activities by the seventh day after surgery. The possible sources and mechanisms of enzyme leakage from tissues after CPB are discussed. The concentration of some physiologically important constituents were determined in pump prime fluids and in the common circulation on bypass. The consequences of haemodilution on small children were undesirably reduced concentrations of magnesium, calcium and albumin, and this state persisted for some days after the end of bypass. Some possible implications of such unphysiological pump primes are discussed. We suggest that ASp AT, Ala AT, CK-MB, magnesium, calcium and urea should be routinely monitored for the first four days after surgery. © 1979.