Postoperative Pattern of Various Hormonal and Metabolic Variables. A Pilot Study in Patients Without Complications Following Cardiac Surgery

• Published in: Current medical research and opinion Vol. 15; no. 4; pp. 339 - 348
• Main Authors: Rümelin, A., Nietgen, G., Pirlich, M., Thum, P., Bischoff, S., Schäfers, H. J., von zur Mühlen, A., Kirchner, E.
• Format: Journal Article
• Language: English
• Published: Reading Informa UK Ltd 1999; Taylor & Francis; Librapharm; Informa Healthcare
• Subjects: Aged; Amino Acids - blood; Aortic Valve; Aortic valve replacement; Biological and medical sciences; Blood Glucose - analysis; Fatty Acids, Nonesterified - blood; Female; Heart Valve Prosthesis Implantation; Hormones - blood; Humans; Male; Medical sciences; Middle Aged; Pilot Projects; Postoperative complications; Postoperative Period; Predictors; Reference Values; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Time Factors; Heart; Human; Hormone; Postoperative; Heart disease; Surgery; Cardiovascular disease; Metabolism
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1185/03007999909116506

Summary
The use of single predictors for threatening postoperative complications are widely accepted. However, a typical pattern of multiple parameters could be more helpful than a single predictor. To study this hypothesis, various variables of normal postoperative changes in patients without postoperative complications were investigated. Secondly, this pattern needs to be compared in the future with those findings in patients with postoperative complications.
Blood parameters of 13 patients undergoing cardiovascular surgery without postoperative complications for 24 hours were evaluated. Samples were obtained on the afternoon before the operation and 1,3, 6,12 and 24 hours after the end of surgey.
At one hour postoperation increased levels of the following parameters were noted: growth hormone (p < 0.0001), glucose (p < 0.0001), insulin (p < 0.001), c-peptide (p < 0.001), lactate (p < 0.002), glutamate (p < 0.0001), aspartate (p < 0.001) and total amino acids (p < 0.07), although the concentration of some amino acids decreased. Three hours postoperatively free fatty acids (p < 0.05) were increased. Total-T3 concentrations were reduced postoperatively. Other parameters were not altered. Most of the parameters returned to normal values during the period of observation.