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Preoperative plasma cholinesterase activity in infants with congenital biliary disorder: A prospective comparative study
Ljiljana Popović1, Tatjana Goranović1, Josipa Kern3, Sandra Alavuk Kundović4, Marina Peklić Iveković5
1MD, PhD, Professor, Consultant Anaesthetist and Intensivist, Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Children's Hospital Zagreb, Zagreb, Croatia; Professor, Faculty of Medicine, University of Zagreb, Croatia.
2MD, PhD, Senior Teaching Assistant, Consultant Anaesthetist and Intensivist, Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Department for Tumours, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; Senior Teaching Assistant, Faculty of Medicine, University of Osijek, Croatia.
3MSc, PhD, Professor, Professor of Medical Informatics, Chair of Department of Medical Statistics, Epidemiology and Medical Informatics, University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Zagreb, Croatia.
4MD, Consultant Anaesthetist and Intensivist, Department of Anesthesiology, Reanimatology and Intensive Care Medicine, Children's' Hospital Zagreb, Zagreb, Croatia.
5MD, Consultant Internist and Intensivist, Department of Internal Medicine, Zagreb University Hospital Centre, Zagreb, Croatia.

Article ID: 100009A05LP2016
doi:10.5348/A05-2016-9-RC-5

Address correspondence to:
Tatjana Goranović
Department of Anesthesiology, Reanimatology and Intensive Care Medicine
University Department for Tumours, Sestre milosrdnice University Hospital Centre Ilica 197
10000 Zagreb
Croatia

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How to cite this article
Popovic Lj, Goranović T, Kern J, Alavuk Kundović S, Peklić Iveković M. Preoperative plasma cholinesterase activity in infants with congenital biliary disorder: A prospective comparative study. Edorium J Anesth 2016;2:20–24.


Abstract
Aims: Plasma cholinesterase (E 3.1.1.8), an enzyme synthesized in the liver, has importance to anesthetic practice for various properties. The aim of our study was to assess the preoperative liver function in terms of plasma cholinesterase activity in infants with severe liver disease.
Methods: Plasma cholinesterase activity, dibucaine number and albumin concentration were prospectively measured in 25 infants with biliary atresia before liver surgery. Twenty healthy infants undergoing elective inguinal hernia repair were included in the control group. Plasma cholinesterase activity was measured by the spectrophotometric method by Ellman. Dibucaine number was determined using benzoylcholine at 25°C in phosphate buffer in the presence of dibucaine. Serum albumin concentration was determined by immunonephelometry as described by Naathelson.
Results: All infants with biliary atresia had significant lower activity of preoperative plasma cholinesterase and albumin concentration compared to the control group (p < 0.0001). In all infants dibucaine number was normal.
Conclusion: This study showed that preoperative plasma cholinesterase activity in infants with biliary atresia reflects the decreased synthetic liver function as well as albumin concentration. The results indicate the possible usefulness of determining plasma cholinesterase activity preoperatively in infants with congenital biliary disorder to avoid altered response with drugs that are metabolized by plasma cholinesterase.

Keywords: Albumin, Congenital biliary disorder, Dibucaine number, Infants, Plasma cholinesterase


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Author Contributions:
Ljljana Popović – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Tatjana Goranović – Conception and design, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Josipa Kern – Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sandra Alavuk Kundović – Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marina Peklić Iveković – Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Ljljana Popović et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.