@article{article_1745062, title={Time-Dependent Effects of Normothermic and Mild Hypothermic Cardiopulmonary Bypass on the De Ritis Ratio}, journal={Journal of Cukurova Anesthesia and Surgical Sciences}, volume={8}, pages={265–270}, year={2025}, DOI={10.36516/jocass.1745062}, author={Dikme, Reşat}, keywords={Kardiyopulmoner bypass, Normotermi, Hipotermi, De Ritis oranı, AST/ALT, Hepatik hasar}, abstract={Aim: This study aims to comparatively evaluate the effects of normothermic and mild hypothermic cardiopulmonary bypass (CPB) strategies on liver function in coronary artery bypass grafting (CABG) operations through the dynamics of the De Ritis ratio. Methods: This retrospective study included 150 patients who underwent CABG with either normothermic (35–37 °C, n=75) or mild hypothermic (28–34 °C, n=75) CPB. Liver function parameters (AST, ALT, De Ritis ratio, GGT, bilirubin) were assessed at the prebypass, postbypass, and postoperative time points. Statistical analysis was performed using SPSS software, with significance set at p <0.05. Results: While De Ritis ratios were comparable during the prebypass period (p=0.751), significantly higher values were observed in the mild hypothermic group during both the postbypass (p=0.032) and postoperative (p=0.048) periods. A significant time-dependent increase in De Ritis ratio was found in both groups (p <0.01). Moreover, a higher proportion of patients in the mild hypothermic group had a De Ritis ratio >2.0 in the postoperative period. The De Ritis ratio showed a negative correlation with GGT at all time points (p <0.001) and a positive correlation with total bilirubin during the prebypass (p <0.001) and postoperative (p=0.006) periods. Female patients consistently showed higher De Ritis ratios than males (p  < 0.05). Conclusion: The normothermic CPB strategy was associated with lower De Ritis ratios compared to hypothermia. The De Ritis ratio may serve as an early indicator of liver function in cardiovascular surgery. Normothermic perfusion may offer hepatoprotective benefits and could be preferred in patients at high risk for liver dysfunction.}, number={3}, publisher={Merthan TUNAY}