Abstract
Hyperglycemia and hypocalcemia frequently complicate open heart surgery (OHS) in hypothermia (HOTH). We have studied 21 children (8wks-6yrs) before, during, and after OHS in HOTH and determined serum glucose (G), insulin (IN), growth hormone (GH), calcium (Ca) calcitonin (CT), and thyroid concentrations:IN conc. were suppressed during HOTH with an attendant increase in serum G levels. During rewarming, IN rebounded rapidly but transiently, suggesting insufficient hormone reserve. Ca declined during HOTH, but increased with rewarming. CT showed no variation with changing body temp. or Ca conc. GH increased with HOTH and post-arrest rewarming, but returned to normal within one hr of surgery. Preliminary thyroid studies suggested decreasing TSH and T4 with HOTH, which returned to baseline upon rewarming. CONCLUSION: OHS in HOTH is associated with profound endocrine changes. Their understanding may greatly aid in the management of OHS patients and improve surgical outcome.
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