Alterations in plasma phosphorus, red cell 2,3-diphosphoglycerate and P50 following open heart surgery.
OBJECTIVE
To evaluate changes in and the correlation between plasma phosphorus, red cell 2,3-diphosphoglycerate (DPG) and adenosine triphosphate (ATP), and P50 in children following heart surgery.


METHODS
Prospective, observational study with factorial design.


METHODS
A pediatric intensive care unit in a university hospital.


METHODS
Twenty children undergoing open heart surgery for congenital heart defects.


METHODS
None.


METHODS
Red cell 2,3-DPG and ATP, P50, plasma phosphorus, and arterial lactate were obtained before and at 1, 8, 16, 24, 48, and 72 hours after surgery. The amount of intravenous fluid and glucose administered, and age of blood utilized were documented. Variables were analyzed by repeated measure analysis of variance followed by paired t-tests. To investigate the relationship between variables at each time point, scatterplot matrices and correlation coefficients were obtained.


RESULTS
There was a reduction in plasma phosphorus, red cell 2,3-DPG, and P50 and an increase in arterial lactate at 1, 8, 16, 24, 48, and 72 hours after surgery. Red cell 2,3-DPG correlated with P50 at 1, 8 and 16 hours. The decrease in the plasma phosphorus correlated with the amounts of intravenous fluid and glucose administered on the day of surgery and on the first and second postoperative days. The age of the blood utilized correlated with the decrease in red cell 2,3-DPG on the day of surgery.


CONCLUSIONS
Reduction in red cell 2,3-DPG, P50, and plasma phosphorus occurs after open heart surgery in children. These changes can potentially contribute to impaired oxygen utilization in the postoperative period, when adequacy of tissue oxygenation is critical.
Hasan
R A
RA
Department of Pediatrics and Cardiovascular Surgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, USA.
Sarnaik
A P
AP
Meert
K L
KL
Dabbagh
S
S
Simpson
P
P
Makimi
M
M
D019794:2,3-Diphosphoglycerate; D000255:Adenosine Triphosphate / Q000097:blood; D000704:Analysis of Variance; D001793:Blood Preservation; D001803:Blood Transfusion; D002675:Child, Preschool; D004163:Diphosphoglyceric Acids / Q000097:blood*; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005440:Fluid Therapy; D005947:Glucose / Q000627:therapeutic use; D006330:Heart Defects, Congenital / Q000097:blood / Q000601:surgery*; D006801:Humans; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption; D010758:Phosphorus / Q000097:blood*; D011184:Postoperative Period; D013997:Time Factors
D004163:Diphosphoglyceric Acids; D007773:Lactates; D019794:2,3-Diphosphoglycerate; D010758:Phosphorus; D019344:Lactic Acid; D000255:Adenosine Triphosphate; D005947:Glucose; D010100:Oxygen