The effect of cardiopulmonary bypass on hemogram parameters in patients operated for tetralogy of fallot

Esra Aktiz Bıçak; Özhan Orhan; Eşe Eda Turanlı; Mustafa Bıçak; Yiğit Kılıç

doi:10.55940/medphar202353

Authors

Esra Aktiz Bıçak Department of Anesthesia and Reamination, SBÜ Diyarbakır Gazi Yaşargil EAH, Diyarbakır , Turkey
Özhan Orhan Department of Child Health and Diseases, Faculty of Medicine, Mardin Artuklu University, Mardin, Turkey
Eşe Eda Turanlı, Department of Child Health and Diseases, SBÜ Diyarbakır Gazi Yaşargil EAH, Diyarbakır , Turkey
Mustafa Bıçak Department of Anesthesia and Reamination, SBÜ Diyarbakır Gazi Yaşargil EAH, Diyarbakır , Turkey
Yiğit Kılıç Pediatric Cardiovascular Surgery, SBÜ Diyarbakır Gazi Yaşargil EAH, Diyarbakır , Turkey

DOI:

https://doi.org/10.55940/medphar202353

Keywords:

Cardiopulmonary bypass, Tetralogy of Fallot, Neutrophil/Lymphocyte ratio, Platelet/Lymphocyte ratio

Abstract

Background: Tetralogy of Fallot (TOF) constitutes 10% of congenital heart diseases. Cardiopulmonary bypass (CPB) is a procedure where the heart pump function and the lungs' gas exchange function are temporarily suspended, and circulation is carried out by the heart-lung machine. Blood is exposed to abnormal physical and chemical trauma during cardiopulmonary bypass. In this study, we aimed to determine the duration of cardiopulmonary bypass on hemogram parameters in patients undergoing corrective surgery for tetralogy of Fallot.

Material and Method: Age, sex, operative time, cardiopulmonary and cross-clamp time, length of stay in hospital and intensive care unit, mortality rate, and blood parameters of patients operated for tetralogy of Fallot were retrospectively evaluated. A total of 28 patients were included in the study.

Result: There was a significant difference between the preoperative and postoperative neutrophil lymphocyte levels (p<0.001, p<0.001, respectively). There was a significant difference between the Neutrophil/Lymphocyte ratios and Platelet/Lymphocyte ratios measured at different times at the preoperative and postoperative periods (p=0.001, p=0.029). The analysis of the distribution of the N/L ratio at the preoperative and postoperative periods showed that the N/L first increased and then decreased. The P/L ratio was measured at 54.1 (34.1-67.3) during the preoperative period; the highest P/L ratio was measured at 67 (46.5-11.3) at the 48th hour of the postoperative period.

Conclusion: The results of this study demonstrated statistically significant differences between WBC, hemoglobin, hematocrit, neutrophil, lymphocyte, N/L and P/L ratio, urea, creatinine, CRP, lactate values measured in the preoperative period and postoperative 24, 48 and 72 hours

References

Hoffman JI. Incidence of congenital heart disease: I. Postnatal incidence. Pediatric cardiology. 1995 May;16:103-13.

Lee MG, Yao JV, Binny S, Larobina M, Skillington P, Grigg LE, Zentner D. Long-term outcome of adult survivors of tetralogy of Fallot. International Journal of Cardiology Congenital Heart Disease. 2021;4:100147. DOI:10.1016/j.ijcchd.2021.100147

Toraman F, Erkek E, Güçlü P, SAYIN J, ARITÜRK C, Ökten EM, Şenay Ş, Karabulut H, Alhan C. Near İnfra Red Spektroskopisi NIRS Gerçekten Doku Saturasyonunu Ölçüyor mu?. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2013;1(3):115-7.

Cobanoglu A, Schultz JM. Total correction of tetralogy of Fallot in the first year of life: late results. The Annals of thoracic surgery. 2002;74(1):133-8. DOI:10.1016/S0003-4975(02)03619-6

AboulHosn J, Child JS. Management after childhood repair of tetralogy of Fallot. Current Treatment Options in Cardiovascular Medicine. 2006;8(6):474-83. DOI: 10.1007/s11936-006-0036-4

Al Habib HF, Jacobs JP, Mavroudis C, Tchervenkov CI, O'Brien SM, Mohammadi S, Jacobs ML. Contemporary patterns of management of tetralogy of Fallot: data from the Society of Thoracic Surgeons Database. The Annals of thoracic surgery. 2010 Sep 1;90(3):813-20. DOI: 10.1016/j.athoracsur.2010.03.110

Annavajjhala V, Valente AM, Lopez L, Sachdeva R, Glickstein JS, Natarajan SS, Buddhe S, Altmann K, Soriano BD, Colquitt JL, Altman CA. Echocardiographic surveillance in children after tetralogy of Fallot repair: Adherence to guidelines?. International Journal of Cardiology. 2020 May 15;307:31-5. DOI 10.1016/j.ijcard.2019.09.075

Wu MH, Wang JK, Chiu SN, Lu CW, Lin MT, Chen CA, Tseng WC. Long-term outcome of repaired tetralogy of Fallot: survival, tachyarrhythmia, and impact of pulmonary valve replacement. Heart Rhythm. 2022;19(11):1856-63. DOI: 10.1016/j.hrthm.2022.06.032

Şaşmazel A. Our short and mid-term results of primary repair in infants less than one year of age with tetralogy of Fallot. Turkish Journal of Thoracic and Cardiovascular Surgery. 2011;19(1):019-023

Naji MA, Alburghaif AH, Saleh NK, Al-hussaniy H. Patient expectations regarding consultation with a family doctor: a cross-sectional study. Medical and Pharmaceutical Journal. 2022;1(1):35-40. DOI: 10.55940/medphar2022-3

Dixon B, Santamaria J, Campbell D. Coagulation activation and organ dysfunction following cardiac surgery. Chest. 2005;128(1):229-36.DOI:10.1378/chest.128.1.229

Saengsin K, Sperotto F, Lu M, Mancebo JG, Sacco E, Godsay M, DiNardo JA, Kheir JN. Administration of Milrinone Following Tetralogy of Fallot Repair Increases Postoperative Volume Administration Without Improving Cardiac Output. Anesthesia & Analgesia. 2023;137(5):1056-65.

Utomo MP, Vitraludyono R, Yupono K. Anaesthesia Perioperative Management in Laparotomy Procedure in Neonates with Tetralogy of Fallot (ToF): A Case Study. European Journal of Medical and Health Sciences. 2023;5(1):16-9. DOI:10.24018/ejmed.2023.5.1.1397

Majiyagbe OO, Akinsete AM, Adeyemo TA, Salako AO, Ekure EN, Okoromah CA. Coagulation abnormalities in children with uncorrected congenital heart defects seen at a teaching hospital in a developing country. PloS one. 2022;17(7):e0263948. DOI: 10.1371/journal.pone.0263948

Patil S, Relan J, Hote M, Kothari SS. Severe thrombocytopenia in tetralogy of Fallot patients: A contraindication for corrective surgery?. Annals of Pediatric Cardiology. 2019;12(3):305.DOI: 10.4103%2Fapc.APC_71_18

Juliana J, Sembiring YE, Rahman MA, Soebroto H. Mortality Risk Factors in Tetralogy of Fallot Patients Undergoing Total Correction. Folia Medica Indonesiana. 2021 Jun 1;57(2):151-7.

Al-hussainy HA, AL-Biati HA, Ali IS. The Effect of Nefopam Hydrochloride on the Liver, Heart, and Brain of Rats: Acute Toxicity and Mechanisms of Nefopam Toxicity. Journal of Pharmaceutical Negative Results. 2022;13(3):393-400.

Omnia MM, Selma E, Najla KH, Salma HM. Diagnosis and Prognosis of Cardiovascular Disease by Inflammatory Markers (Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio). International Journal of Innovative Science and Research Technology. 2020;5(1):353-58. DOI: 10.47750/pnr.2022.13.03.061

Hayashi H, Takamura H, Ohbatake Y, Nakanuma S, Tajima H, Fushida S, Onishi I, Tani T, Shimizu K, Ohta T. Postoperative changes in neutrophil-to-lymphocyte ratio and platelet count: A simple prognostic predictor for adult-to-adult living donor liver transplantation. Asian journal of surgery. 2018;41(4):341-8. 10.1016/j.asjsur.2017.02.004

Liu F, Lin X, Lin Y, Deng X, Guo Y, Wang B, Dong R, Bi Y. The effect of neostigmine on postoperative delirium after colon carcinoma surgery: a randomized, double-blind, controlled trial. BMC anesthesiology. 2022;22(1):1-0.

Kierans SJ, Taylor CT. Regulation of glycolysis by the hypoxia‐inducible factor (HIF): implications for cellular physiology. The Journal of physiology. 2021 Jan;599(1):23-37.