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Canadian Journal of Anesthesia, Vol 28, 334-338, Copyright © 1981 by Canadian Anesthesiologists' Society

Cortisol and Antidiuretic Hormone Responses to Stress in Cardiac Surgical Patients

YASU OKA 1, SHIGEHARU WAKAYAMA 1, TSUTOMU OYAMA 1, LOUIS R. ORKIN 1, RONALD M. BECKER 1, M. DONALD BLAUFOX 1, and ROBERT W. M. FRATER 1

1 Department of Anesthesiology, Cardiothoracic Surgery and Nuclear Medicine. Albert Einstein College of Medicine, Bronx, New York and Department of Anesthesiology, University of Hirosaki, Hirosaki, Japan

Dr. Oka at Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York, 10461.

The hormonal responses to anaesthesia and cardiac surgery were studied in patients undergoing valve or coronary bypass surgery. Marked increases in antidiuretic hormone levels as a result of surgical stress were seen, and were of approximately equal magnitude in both groups. Although both groups also showed marked increases in plasma cortisol levels in response to operations, this response appeared to be relatively blunted in valve surgery patients, especially at the end of operation and in the intensive care unit. This blunted cortisol response may be a manifestation of exhaustion of adrenocortical reserves in valvular surgical patients whose sympathoadrenal system has already been chronically stimulated by a low output state.

The important role of the neuroendocrine system in maintaining homeostasis postoperatively has long been recognized; this relative cortisol deficiency may be astiologically related to poor postoperative recovery in critically ill valvular surgery patients.

Key Words: CARDIAC SURGERY, stress response






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Copyright © 1981 by the Canadian Anesthesiologists' Society.