TY - JOUR T1 - Time-Dependent Effects of Normothermic and Mild Hypothermic Cardiopulmonary Bypass on the De Ritis Ratio TT - Normotermik ve Hafif Hipotermik Kardiyopulmoner Bypass'ın De Ritis Oranı Üzerindeki Zamana Bağlı Etkileri AU - Dikme, Reşat PY - 2025 DA - September Y2 - 2025 DO - 10.36516/jocass.1745062 JF - Journal of Cukurova Anesthesia and Surgical Sciences JO - J Cukurova Anesth Surg PB - Merthan TUNAY WT - DergiPark SN - 2667-498X SP - 265 EP - 270 VL - 8 IS - 3 LA - en AB - 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 KW - Cardiopulmonary bypass KW - Normothermia KW - Hypothermia KW - De Ritis ratio KW - AST/ALT KW - Hepatic injury N2 - Amaç: Bu çalışma, koroner arter bypass greftleme (KABG) operasyonlarında normotermik ve hafif hipotermik kardiyopulmoner bypass (KPB) stratejilerinin karaciğer fonksiyonu üzerindeki etkilerini De Ritis oranının dinamikleri üzerinden karşılaştırmalı olarak değerlendirmeyi amaçlamaktadır.Yöntem: Retrospektif olarak tasarlanan bu çalışmaya, normotermik (35–37 °C, n=75) veya hafif hipotermik (28–34 °C, n=75) KPB altında KABG uygulanan toplam 150 hasta dâhil edilmiştir. Karaciğer fonksiyon parametreleri [AST, ALT, De Ritis oranı (AST/ALT), GGT ve bilirubin] prebypass, postbypass ve postoperatif dönemlerde değerlendirilmiştir. İstatistiksel analizler SPSS yazılımı kullanılarak gerçekleştirilmiş ve anlamlılık düzeyi p CR - 1.Elawady M, Elderie A, Sanad M, Amer G. Normothermia versus Hypothermia during Cardiopulmonary Bypass in Cases of Repair of Atrioventricular Septal Defect. Anesth Essays Res. 2020;14:112-118. [Crossref] CR - 2.Bianco V, Kilic A, Aranda-Michel E, Chen Sultan I, Serna-Gallegos D, Navid F, Dunn‐Lewis C. Mild hypothermia versus normothermia in patients undergoing cardiac surgery. JTCVS Open. 2021;7:230-242. [Crossref] CR - 3.As A, Amaç B, Yavuz Ş, Engin M, Abanoz M. Comparison of hypothermic and normothermic cardiopulmonary bypass in patients undergoing coronary artery bypass graft surgery. Eur Res J. 2025. [Crossref] CR - 4.Hood S, McCall P, Evans R, Bellomo R, Lankadeva Y, Marino B, May C, Cochrane A, Jufar A. Influence of moderate hypothermia on renal and cerebral haemodynamics and oxygenation during experimental cardiopulmonary bypass in sheep. Acta Physiol. 2022;236. [Crossref] CR - 5.Arapi B, Zeka M, Ibrahimi A, Kuci S, Lilaj K. Troponin I, and Lactic Acid variations, during Cardiopulmonary Bypass under Moderate Hypothermia vs Normothermia. Alban J Trauma Emerg Surg. 2023;7. [Crossref] CR - 6.Man K, Liu J. Mechanistic Insight and Clinical Implications of Ischemia/Reperfusion Injury Post Liver Transplantation. Cell Mol Gastroenterol Hepatol. 2023;15:1463-1474. [Crossref] CR - 7.Feng J, Zhao X, Zhu X, Jiao Y, Yang H, Li Q. Protein modifications in hepatic ischemi a-reperfusion injury: molecular mechanisms and targeted therapy. Front Immunol. 2025;16. [Crossref] CR - 8.Huang R, Wang J, Sharma M, Ginther R, Forbess J, Guleserian K, Riegel M. The impact of temperature and pump flow rate during selective cerebral perfusion on regional blood flow in piglets. J Thorac Cardiovasc Surg. 2013;145:188-194. [Crossref] CR - 9.Dworschak M, Hoetzenecker K, Hillebrand C, Tschernko E, Schlein J, Schwarz S, Veraar C, Menger J. Postoperative Liver Dysfunction After Lung Transplantation With Extracorporeal Life Support and 1-Year Mortality—A Cohort Study. J Cardiothorac Vasc Anesth. 2025. [Crossref] CR - 10.Shaikh SM, Varma A, Kumar S, Acharya S, Patil R. Navigating Disease Management: A Comprehensive Review of the De Ritis Ratio in Clinical Medicine. Cureus. 2024;16:e64447. [Crossref] CR - 11.Durak K, Nubbemeyer K, Zayat R, Spillner J, Dineva S, Kalverkamp S, Kersten A. De Ritis Ratio to Predict Clinical Outcomes of Intermediate- and High-Risk Pulmonary Embolisms. J Clin Med. 2024;13:2104. [Crossref] CR - 12.Bağış M, Amaç B, Padak M. Comparison of De Ritis Rate for Del Nido Versus Blood Cardioplegia in Patients Who Underwent Coronary Artery Bypass Graft Under Cardiopulmonary Bypass. Cukurova Anestez Cerrah Bilim Derg. 2024. [Crossref] CR - 13.Bautin A, Artyukhina Z, Zinserling V, Marichev A, Semenova N, Murashova L, Osovskikh V, Radovskiy A. NO Addition during Gas Oxygenation Reduces Liver and Kidney Injury during Prolonged Cardiopulmonary Bypass. Pathophysiology. 2023;30:484-504. [Crossref] CR - 14.Kumar R, Kumar B, Tewarson V, Kumar S, Hakim MZ, et al. Hyperbilirubinemia and hepatic dysfunction in patients undergoing cardiac surgery: Predictors and outcome—A single centre prospective study. Int J Cardiovasc Med. 2024;3(5). [Crossref] CR - 15.Hayashida N, Shoujima T, Teshima H, et al. Clinical outcome after cardiac operations in patients with cirrhosis. Ann Thorac Surg. 2004;77:500-505. [Crossref] CR - 16.Singh, S. (2024). Hyperbilirubinemia and hepatic dysfunction in patients undergoing cardiac surgery: Predictors and outcome- A single center prospective study. International Journal of Cardiovascular Medicine. [Crossref] CR - 17.Keizman E, Mishaly D, Ram E, et al. Normothermic Versus Hypothermic Norwood Procedure. World J Pediatr Congenit Heart Surg. 2022;14:125-132. [Crossref] CR - 18.Sabzi F, Faraji R. Liver Function Tests Following Open Cardiac Surgery. J Cardiovasc Thorac Res. 2015;7:49-54. [Crossref] CR - 19.Caputo M, Pike K, Baos S, Sheehan K, Selway K, Ellis L, Stoica S, Parry A, Clayton G, Culliford L, Angelini GD, Pandey R, Rogers CA. Normothermic versus hypothermic cardiopulmonary bypass CR - 20.Salehi Abarghouei F, Chahkandi T, Shaban S, Raeiszadeh Bajestani SF, Soleimani MH, Amouzeshi A, Salehi S. Hepatopathy and acute kidney injury Following Corrective Cardiac Surgery with cardiopulmonary bypass pump in Pediatric with Congenital Heart Defects. ARYA Atheroscler. 2025;21:10-17. [Crossref] CR - 21.Seo YJ, Shim YS, Lee HS, et al. Updated reference ranges for aminotransferase levels of Korean children and young adolescents based on the risk factors for metabolic syndrome. Sci Rep. 2022;12:15739. [Crossref] 22.Mera JR, Dickson B, Feldman M. Influence of gender on the ratio of serum aspartate aminotransferase (AST) to alanine aminotransferase (ALT) in patients with and without hyperbilirubinemia. Dig Dis Sci. 2008;53:799-802. [Crossref] UR - https://doi.org/10.36516/jocass.1745062 L1 - https://dergipark.org.tr/tr/download/article-file/5065653 ER -