Comparing the Effects of Pulsatile and Nonpulsatile Perfusion on the Endocrine System in Open Heart Surgery

W e investigated the effects of flow characteristics in cardiopulmonary bypass on the endocrine system, and 22 patients were included in two groups according to the flow characteristics applied: pulsatile and nonpulsatile flow. The honnones studied were TSH, T3, T4, Free T3 free T4, ACTH, cortisol aldosterone, insuline and growth honnone; also glucose measurements were perfonned in the same periods. The honnon !eve! detections were made in all patients five times as in the preoperative period, after beginning of general anesthesia, at the 30th and 60th minutes of perfusion, and at 24th hour postoperatively. It was acertained that, in the perfusion period, T3 stayed at higher postoperatively. It was acertained that, in the perfusion period, T3 stayed at higher levels and FT3 diminished oppositely in the pulsatile group. There was not significant difference between the two groups in tenns of T4 and FT4. For ACTH, only in the 24th hour period, the mean !eve! of the pulsatile group was significantly high, and this was also true for cortisole in the same period; however, the difference was not statistically significant. For aldosterone, the mean levels were lower in the pulsatile group while the differences were not statistically significant. Mean !eve! of insulin was significantly lower in the pulsatile group by the 60th minutes of perfusion. The similar finding was also accurate for glucose in the perfusion period. The mean !eve! of growth honnone was significantly higher in the pulsatile group by the 60th minutes of perfusion. The lower level detections of insulin in the perfusion period of the pulsatile group was noticed and this could be related with the lower glucose levels and higher anti-insulinary bonnone levels.