Influence of electrolyte imbalance on arrhythmias in cardiovascular surgery with extracorporeal circulation.

Influência do desequilíbrio eletrolítico nas arritmias na cirurgia cardiovascular com circulação extracorpórea.

Abstract

Introduction: The electrolyte imbalance present in patients undergoing cardiovascular surgery with cardiopulmonary bypass may be due to the elements that make up the cardioplegic solution, among other factors. Therefore, changes in electrolyte levels can lead to arrhythmias during the period of myocardial reperfusion, compromising homeostasis and the patient's prognosis. Justification: the occurrences of arrhythmias in cardiovascular surgeries have led to rational questioning in the monitoring of electrolytes during and after the surgical procedure. The issue in question is whether electrolyte dysfunction is related to arrhythmias during the reperfusion period and after cardiopulmonary bypass in order to guide the professional class on this particular monitoring. Objective: the present study analyzed the relationship between cardiac arrhythmia and electrolyte disturbance in patients undergoing cardiovascular surgery after a period of ischemia followed by myocardial reperfusion. Methodology: Data were collected from 20 patients undergoing cardiovascular surgery with extracorporeal circulation, who underwent ischemia and myocardial protection. The following variables were analyzed in the periods before, during and after extracorporeal circulation: sex, age, weight, ischemia time, sodium, potassium, calcium and magnesium. After opening the aortic clamp, that is, during myocardial reperfusion, it was observed whether there was an arrhythmia, the type of arrhythmia and its treatment or whether there was no arrhythmia. Thus, the recorded data were analyzed with a view to demonstrating whether there were changes in electrolyte values ​​during the procedure and whether the changes are predictive factors for arrhythmias. Results: Demonstrated an increase in arrhythmia in female patients (25%) and the stability of electrolytes sodium, potassium, calcium and magnesium within acceptable standards. There were no significant changes (p: > 0.05) between patients who had arrhythmia and those who did not. However (45%) of the patients studied developed some arrhythmia. Conclusion: It was possible to evaluate electrolyte levels in the perioperative period and arrhythmias. With the stability of the electrolyte balance and the presence of arrhythmias, other eventualities may be related to arrhythmias at the time of reperfusion of the myocardial tissue in addition to hydroelectrolyte dysfunction, requiring specific studies.