Abstract
Hyperglycemia and hypocalcemia frequently complicate open heart surgery (OHS) in hypothermia (HOTH). We have studied 21 children (6 wks-6yrs) before, during, and after OHS in HOTH and determined serum glucose (G), insulin (IN), growth hormone (GH), calcium (Ca), calcitonin (CT), and thyroid hormone concentrations: IN conc. were suppressed during HOTH with an attendant increase in serum G. IN rebounded rapidly but transiently during rewarming. Ca declined during HOTH and increased only after Ca infusion during rewarming. CT showed no variation with changing body temp. GH increased with HOTH and during post-arrest rewarming, but returned to normal within one hour of surgery. RIA-T4 and T3 decreased markedly with HOTH, partly because of diminished TBG binding. TSH showed a decrease rather than the expected increase with cooling. CONCLUSION: OHS in HOTH is associated with profound endocrine changes. Their understanding is essential to improvement of management and surgical outcome.
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