Creatine kinase activity and temperature in children after cardiac surgery

The preoperative and postoperative serum creatine kinase (CK) activity and postoperative temperatures were studied in children undergoing surgery for congenital heart disease. Using multiple linear and logistic regression and analysis of variance, associations were found between postoperative CK activity (>2,000 IU/L) and the use of succinylcholine, aortic cross-clamp time (>30 minutes), cardiopulmonary bypass time (>60 minutes), the development of fever (>38.5°C), and complications. Complications were defined as hemodynamic instability, poor peripheral perfusion, metabolic acidosis, and eventual multiple organ failure. Associations were also found between postoperative fever and the development of complications. The results suggest that children who develop serum CK elevations greater than 2,000 IU/L and fever greater than 39.5°C during the early postoperative period after cardiac surgery more often develop serious complications.