The effect on intermediary metabolism of open-heart surgery with deep hypothermia and circulatory arrest in infants of less than 10 kilograms body weight. A preliminary study

Abstract

The effects of hypothermic open-heart surgery with circulatory arrest upon intermediary metabolism and endocrine function in small children are still poorly understood. This report presents data obtained in a preliminary study in which seven children of p<0·05) to approximately twice the levels reported in adults. Unlike the other hormones, growth hormone concentrations revealed remarkably uniform change, similar to those reported in 'high responding' adults with peak values of 124 ± 26 mU/L, observed during cardiopulmonary bypass. Cortisol concentrations showed no significant changes throughout the study. Thus, the response of small infants to these procedures differed both qualitatively and quantitatively from that reported in adults. The results suggest that the nature of the prime fluid may be of major importance in the metabolic consequences of such surgery and that glucose and lactate may be better avoided in the pump prime.