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(Circulation. 1965;31:I-150.)
© 1965 American Heart Association, Inc.

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Plasma and Urinary Amino Acids During and After Cardiopulmonary Bypass

Preliminary Report

ISMAIL DIMILILER M.D.¹ ROBERT G. TROUT M.D.¹

¹ From the Thoracic and Cardiovascular Surgical Service and the Research Institute of the Presbyterian Hospital, Philadelphia, Pennsylvania.

The amount of amino acids in the blood during cardiopulmonary bypass has been studied in two stages by thin-layer chromatography with modifications necessary for this study. In the first stage fresh heparinized blood was recirculated for four to five hours in a heart-lung machine containing a rotating disc oxygenator and nonocclusive roller pumps. This apparatus caused considerable hemolysis, and there was a definite increase in most of the amino acids. Histidine, proline, hydroxyproline, serine, alanine, threonine, aspartic acid, asparagine, glycine, glutamic acid, tyrosine, and tryptophane showed a marked increase; arginine, lysine, valine, cystine, cysteine, and phenylalanine showed a moderate increase. Leucine, isoleucine, and methionine did not change. In the second part of the study, similar investigations were done on blood and urinary samples taken during open-heart operations on five cases. Eight to ten blood samples and a similar number of urinary samples were studied and evaluated repeatedly. The apparatus used, which contained a stationary screen oxygenator and occlusive roller pumps, caused minimal hemolysis. The amino acids increased similarly during open-heart surgery, and this increase continued until four hours postoperatively. During the actual bypass the renal excretion of amino acids slowed down considerably; however, on the evening of the operation there was an increase which continued for four to five days. The hyperamino-acidemia seemed to be related to plasma protein breakdown.