• R A Hasan, A P Sarnaik, K L Meert, S Dabbagh, P Simpson, and M Makimi.
• Department of Pediatrics and Cardiovascular Surgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, USA.
• J Cardiovasc Surg. 1994 Dec 1;35(6):491-7.

ObjectivesTo 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.Experimental DesignProspective, observational study with factorial design.SettingA pediatric intensive care unit in a university hospital.PatientsTwenty children undergoing open heart surgery for congenital heart defects.InterventionsNone.MeasuresRed 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.ResultsThere 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.ConclusionsReduction 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.

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