[Follow-up of hormonal and metabolic parameters after heart operations in childhood].
FORMULATION OF QUESTION: Determination of extent and duration of stress metabolism in children after cardiac surgery.


METHODS
Before and 5 days following cardiac surgery glucose, cortisol, glucagon, insulin, human growth hormone, lactate, urea, free fatty acids, triglycerides, total-T3, total-T4, TSH and thyroxine-binding globulin were determined in 20 infants and children (1/3-12 3/4 years).


RESULTS
In the first postoperative hours we found increased values for glucose, cortisol, lactate and free fatty acids, decreasing values for glucagon, human growth hormone and thyroid hormones including TSH. Around the 3rd postoperative day blood glucose normalized, glucagon, insulin, human growth hormone and thyroid hormones increased. Patients with preoperative cyanosis (n = 11) showed a slightly more protracted course than patients without (n = 9).


CONCLUSIONS
During the postoperative period the pattern of stress metabolism predominated with compromised utilisation of glucose and elevated oxygenation of endogenous lipid depots. The postoperatively decreased thyroid hormones were interpreted as a measure to lower the basic metabolic rate. Round about the 3rd postoperative day normalized glucose levels and rising glucagon, insulin, human growth hormone and thyroid hormones/signaled the change to an anabolic metabolism.
Buheitel
G
G
Klinik mit Poliklinik für Kinder und Jugendliche, Friedrich-Alexander-Universität Erlangen-Nürnberg.
Scharf
J
J
Dörr
H G
HG
Ramsauer
T
T
Schuderer
E
E
Singer
H
H
D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000503:physiopathology / Q000601:surgery*; D006728:Hormones / Q000097:blood*; D006801:Humans; D007223:Infant; D008055:Lipids / Q000097:blood; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology*; D013963:Thyroid Hormones / Q000097:blood; D014508:Urea / Q000097:blood
D001786:Blood Glucose; D006728:Hormones; D008055:Lipids; D013963:Thyroid Hormones; D014508:Urea
Verlauf von hormonellen und metabolischen Parametern nach Herzoperationen im Kindesalter.