Immunologic Detection of Myoglobinuria After Cardiac Surgery

Abstract

Six of 16 patients, on the 1st day after cardiac surgery, demonstrated myoglobinuria in concentrations of less than 0.015 mgm/ml-0.105 mgm/ml. Myoglobin was detected and quantified immunologically by precipitin reaction with specific antiserum. Seven patients had myoglobin present in their serum at this time. None of 20 patients recovering from other surgical procedures had myoglobinuria. One of 9 of these patients had trace amounts of serum myoglobin. All of the myoglobinuric patients had open heart surgery, and antecedent valvular heart disease; 5 of the 6 had antecedent congestive heart failure and heart valve replacement operations. The incidence of myoglobinuria was related to both the total time of surgery and to the time of use of pump cardiac by-pass apparatus. The origin of the serum and urine myoglobin is not known. It probably was of cardiac origin, although skeletal muscle may also be a source. A case history of a patient, with dermatomyositis, with myoglobinuria which was detected with antiserum is presented to illustrate renal failure occuring as a consequence of myoglobinuria.