Serum levels of gastric-acid-stimulating factors in children undergoing open heart surgery.
OBJECTIVE
Upper gastrointestinal (GI) bleeding is a feared consequence of open heart surgery in children. Increased gastric acid secretion is a known key factor in the pathogenesis of gastritis and upper intestinal ulcerations. The aim of this study is to evaluate the serum kinetics of acid-stimulating factors and associated perioperative parameters after heart surgery in children.


METHODS
Fifteen pediatric patients after open heart surgery and 15 children with cardiac catheterization were included in this study. Serum levels of gastrin, histidine, alanine, and tryptophan were analyzed before and up to 26 h after surgery.


RESULTS
In the postoperative period there was a significant elevation of gastrin with a peak at 4 h after surgery. Serum histidine was increased significantly immediately after surgery only in patients undergoing heart surgery with cardioplegia. No association of gastrin and histidine elevation with ischemia, perfusion time or lactate was observed.


CONCLUSIONS
Factors that are responsible for postoperative gastrin elevation still have to be determined. Circumstances of extracorporeal circulation (ECC) in low-risk patients most likely do not lead to relevant elevation of amino acids with acid-stimulatory effect in our study population.
Breuer
Christian
C
Kinder- und Jugendklinik, Universitätsklinikum Erlangen, 91054, Erlangen, Germany.
Rauh
Manfred
M
Zink
Stefan
S
Koch
Andreas
A
Weyand
Michael
M
Dittrich
Sven
S
Köhler
Henrik
H
D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005744:Gastric Acid / Q000378:metabolism*; D005745:Gastric Acidity Determination; D005755:Gastrins / Q000097:blood* / Q000378:metabolism; D005756:Gastritis / Q000209:etiology / Q000517:prevention & control; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000517:prevention & control
D005755:Gastrins