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Effects on the Endocrine System of Pulsatile and Nonpulsatile Perfusion in Heart Surgery

Erdem Silistreli, MD, Hüdai Çatalyürek, MD, Nejat Sariosmanolu, MD, Ünal Açikel, MD, Eyüp Hazan, MD, Öztekin Oto, MD

Department of Thoracic & Cardiovascular Surgery Dokuz Eylul Medical Faculty zmir, Turkey

For reprint information contact: Erdem Silistreli, MD Tel: 90 232 277 5867 Fax: 90 232 277 2165 email: silistre{at}cs.med.deu.edu.tr Mithatpasa Cad. No. 257/5, Balcova, zmir 35340, Turkey.

The effects of cardiopulmonary bypass on the endocrine system were investigated in 10 patients who had pulsatile perfusion and in another 10 who had nonpulsatile perfusion during coronary bypass or valve replacement surgery. Measurements were made of thyroid-stimulating hormone, free and total triiodothyronine, free and total tetraiodothyronine, adrenocorticotropic hormone, cortisol, aldosterone, growth hormone, insulin, and glucose at 5 fixed time intervals up to 24 hours postoperatively. In the perfusion period, free and total triiodothyronine levels were less depressed in the pulsatile group. The mean level of growth hormone was significantly higher in the pulsatile group after 60 minutes of perfusion. The mean levels of insulin and glucose were significantly lower in the pulsatile group after 60 minutes of perfusion. Other changes were not statistically significant. We concluded that pulsatile perfusion was of benefit in stabilizing glucose and some hormone levels.

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