[Significance of AKBR as an indicator of liver injury after cardiopulmonary bypass].

AKBR is a metabolic indicator related to NAD-linked dehydrogenase system, according to the REDOX theory. In order to estimate whether AKBR is a sensitive indicator of liver injury or not, we measured AKBR before and immediately after cardiopulmonary bypass (CPB) in 20 patients undergoing cardiac surgery and thoracic aortic aneurysmectomy. Twenty patients were divided into two groups: one with AKBR more than 0.7 (normal group) and the other with AKBR less than 0.7 (abnormal group). The AKBR in the abnormal group was significantly decreased after CPB (p < 0.05), though the AKBR in the normal group was unchanged. In addition, the normal group significantly showed high AKBR compared to the abnormal group after CPB (p < 0.01). Among 5 patients with GPT more than 50 IU/l, the number of patients with AKBR more than 0.7 was zero and with AKBR less than 0.7 was 5 patients. The normal group has a lower risk of liver injury than the abnormal group. The normal group had a higher hepatic perfusion pressure compared with abnormal group. However, there were not significant differences in the cardiac functions (cardiac output, LVSWI and RVSWI) after the CPB between two group, whereas the CPB time and the aortic clamping time in the abnormal groups were longer than those in the normal group. We concluded that the AKBR is a sensitive indicator of liver function after the CPB.