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Adrenal Function During Extracorporeal Circulation

W. W. CLEVELAND, MD; A. R. CLERCH, MD; R. SLONIM, MD; H. L. GADBOYS, MD; R. S. LITWAK, MD
Arch Surg. 1965;90(6):868-870. doi:10.1001/archsurg.1965.01320120070003.
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IT HAS BEEN clearly established that surgical procedures may evoke a significant adrenal response as reflected by increased concentrations of corticosteroids in plasma and urine during and after operation.1-3 The response to thoracotomy has been shown by Viikari and Thomasson3 to involve marked increases in plasma corticosteroid concentrations. The incorporation of extracorporeal circulation into the performance of cardiac surgery does, however, introduce both mechanical and physiological factors which may complicate the adrenal response. Because of this and the limited existing data it was felt of value (1) to study changes in plasma corticosteroids during operations involving extracorporeal surgery, (2) to compare these changes in groups of patients surviving and succumbing from the procedure, and (3) to assess the effects of hypothermia and sequestration on plasma corticosteroid concentrations. It is recognized that the concentration of corticosteroids in plasma results from a complex adjustment of production, distribution, conjugation, and excretion,

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