Three hundred consecutive adult patients having cardioaortic surgery under the cardiopulmonary bypass for a variety of cardioaortic lesions were evaluated retrospectively for postoperative hyperbilirubinemia(above 5mg/100ml). We found
twenty-eight
patients with postoperative hyperbilirubinemia and divided them into two groups according to the postoperative day of peak s-bilirubin. Group A was the patients with a peak s-bilirubin level within three days, and group B above three days
postoperatively. Group B was divided into group S(survival) and group D(death). We had compaired the survival & death group and observed the correlation between the decreasing tendency of postoperative s-bilirubin & the nutrition per os in group
B.
The incidence of postoperative hyperbilirubinemia, as defined by a s-bilirubin concentration of 5.0mg/100ml or greater, was 9.3%. The mortality rates of group A & B were 0.0% and 35.7% respectively. Important contributing factors between group A
&
B
were the age, duration of ICU, Max. DOAB(maximum dose of catecholamine used), amount of blood transfused during or shortly after surgery and preoperative pulmonary hypertension(main pulmonary artery pressure>30mmHg) and backward heart failure.
The
risking factors of group D compared to group S were as follows-the age, preoperative & postoperative SGOT(serum glutamic-oxaloacetic transaminase), postoperative total & indirect bilirubin, cardiopulmonary bypass time, duration of ICU &
mechanical
ventilation, Max. DOAG, preoperative pulmonary hypertension and backward heart failure. The six patients in group B showed a good correlation between the decreasing point of s-bilirubin and the starting day of oral or tube feedings. (Korean J
Thoracic
Cardiovas Surg 1994; 27:170-179)
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