COMPARATIVE STUDIES OF PULSATILE AND NON-PULSATILE FLOW DURING CARDIOPULMONARY BYPASS .2. EFFECTS ON ADRENAL SECRETION OF CORTISOL

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  • 1 January 1978
    • journal article
    • research article
    • Vol. 75  (4) , 574-578
Abstract
Previous studies have indicated that a significant reduction in plasma cortisol levels occurs during nonpulsatile cardiopulmonary bypass as a result of adrenocortical hypofunction. The Stockert pulsatile pump system was employed in a comparative study of plasma cortisol levels in 20 patients subjected to pulsatile or nonpulsatile perfusion during open-heart surgery. The plasma cortisol response pattern in the nonpulsatile group was identical to the pattern previously described, with no significant rise in cortisol levels during the period of perfusion. In the pulsatile group, however, plasma cortisol levels rose significantly during perfusion, reaching a mean level at the end of perfusion which was highly significantly greater than that in the nonpulsatile group (P < 0.001). Correction of the plasma cortisol values for the effect of hemodilution was performed and, again, corrected cortisol values indicated a highly significant increase in end-bypass levels in the pulsatile groups (P < 0.001). The reduction in cortisol secretion during nonpulsatile bypass may be prevented by the use of pulsatile perfusion.