Postoperative hyperamylasaemia in cardiac surgery.
The mechanism of postoperative hyperamylasaemia was studied in 48 patients undergoing coronary artery bypass grafting (CABG). Mild hyperamylasaemia developed in 87% of the patients, and in 10% the serum amylase activity was > 1000 U/l. Serial measurements of serum salivary (S-) and pancreatic (P-) isoamylases indicated that hyperamylasaemia was highest 24 hours after CABG and consisted mainly of P-amylase component. Serum creatinine, creatinine clearance and urinary albumin concentration remained normal after CABG, excluding severe renal damage. The fractional clearance (i.e. relative to creatinine clearance) of P-amylase decreased more than of S-amylase (from 3.6 to 0.9% vs 1.3 to 0.8%). Decreased rate of excretion into urine, rather than pancreatic cellular damage, is the main source of hyperamylasaemia after CABG.
Paajanen
H
H
Department of Surgery, Kuopio University Hospital, Finland.
Harmoinen
A
A
Sisto
T
T
Tarkka
M
M
Nordback
I
I
D000368:Aged; D000681:Amylases / Q000097:blood / Q000378:metabolism* / Q000652:urine; D000704:Analysis of Variance; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000097:blood / Q000378:metabolism* / Q000652:urine; D016014:Linear Models; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis / Q000201:enzymology / Q000209:etiology*; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism; D011184:Postoperative Period; D011300:Preoperative Care
D007527:Isoenzymes; D000681:Amylases