Liver Function Test Alterations in Patients On Veno Arterial And Veno Venous Extracorporeal Membrane Oxygenation

Background and Aim: Early hepatic dysfunction especially bilirubin levels have been found to be an independent reliable clinical prognostic factor in ECMO patients. The aimof this study is liver impact of hyperbilirubinemia on 30-day mortality Methods: Retrospective prospectively maintained registry from a tertiary cardiac center Bangalore between August 2020 Dec 2022. Inclusion criteria: adult patients aged 18-65yrs initiated with normal preoperative or pre function tests hepatobiliary imaging. Exclusion known chronic disease, concomitant sepsis, drug induced injury, within 48 hrs initiation. Results: 76 cases included - 58 Veno-arterial (VA) 18 Veno-Venous (VV)ECMO. Abnormal LFT was noted 73 (96.1%) (100% VA 83.3% VV ECMO) occurred majority 24 hours Isolated bilirubinemia seen 47 (61.8%) cases, hepatitic pattern 25(32.9%) cholestatic 1 case (1.3%). 38 (52.1%) these had direct bilirubinemia, 19 (26%) mixed 16 (21.9%) indirect bilirubinemia. Bilirubinemia severe(>6mg/dl) 41(56.2%), moderate (3-6mg/dl) 20(27.4%) mild (<3) 12 (16.4%) cases. happened 51 cases- High Bilirubin level >6 associated high (97.1%) (between 3-6) 40% mortality. No observed isolated Conclusion: very common multifactorial cause. Direct rates hospital Managing cohort challenging due heterogeneity indications, multiorgan lack data guidelines.