TY - JOUR
T1 - Hormonal response of the premature primate to operative stress
AU - Florentina Taylor, A.
AU - Lally, Kevin P.
AU - Chwals, Walter J.
AU - McCurnin, Donald C.
AU - Gerstmann, Dale R.
AU - Shade, Robert A.
AU - deLemos, Robert A.
N1 - Funding Information:
From the Department of Physiology and Medicine, Southwest Foundation for Biomedical Research, San Antonio, TX; the Divisions of Pediatric Surgery, The University of Texas Health Science Center at Houston, Houston, TX, and Bowman Gray School of Medicine, Winston-Salem, NC; and the Departments of Neonatology Wilford Hall USAF Medical Center, Utah Valley Regional Medical Center, and The University of Southern California, Los Angeles, CA. Presented at the 25th Annual Meeting of the Pacific Association of Pediatric Surgeons, Albuquerque, New Mexico, May 17-21, 1992. Supported in part by the American Heart Association-Texas Afihate Grant 886604, and SCOR Grant HL 36536. Address reprint requests to Kevin P. Lally, MD, Division of Pediatric Surgery, University of Texas Medical School Houston, 6431 Fannin, Suite 6.264, Houston, TX 77030. Copyright 0 1993 by W.B. Saunders Company 0022-3468/9312806-0023$03.00/O
PY - 1993/6
Y1 - 1993/6
N2 - There are few data on the hormonal response to operation in the premature infant. Studies examining the response of newborn human infants have been performed on patients beyond the first few days of life, where some adaptation to postnatal life has occurred. This study evaluated the response of the newly born premature primate to surgical stress. Premature baboons (75% gestation) were intubated, mechanically ventilated and underwent thoracotomy at 2 hours of life with exposure of the ductus arteriosus (PDA). In group 1, formalin was infiltrated to keep the ductus patent. In group 2, the PDA was ligated. Controls had no operation. Blood was drawn at 0, 6, 24, 48, 72, and 96 hours of age. Echocardiograms were performed to confirm patency or closure of the ductus and to monitor cardiac function. Epinephrine, norepinephrine, renin, and cortisol levels were measured. Cortisol levels rose in all groups. Operation stimulated a marked increase in catecholamine and renin levels in both operative groups, which was more marked in the group with PDA ligation at 24 hours. These data reflect expected pathophysiology since early PDA ligation exerts additional hemodynamic demand on the heart. In conclusion, the premature primate is able to mount a significant and severity-dependent endocrine response to stress.
AB - There are few data on the hormonal response to operation in the premature infant. Studies examining the response of newborn human infants have been performed on patients beyond the first few days of life, where some adaptation to postnatal life has occurred. This study evaluated the response of the newly born premature primate to surgical stress. Premature baboons (75% gestation) were intubated, mechanically ventilated and underwent thoracotomy at 2 hours of life with exposure of the ductus arteriosus (PDA). In group 1, formalin was infiltrated to keep the ductus patent. In group 2, the PDA was ligated. Controls had no operation. Blood was drawn at 0, 6, 24, 48, 72, and 96 hours of age. Echocardiograms were performed to confirm patency or closure of the ductus and to monitor cardiac function. Epinephrine, norepinephrine, renin, and cortisol levels were measured. Cortisol levels rose in all groups. Operation stimulated a marked increase in catecholamine and renin levels in both operative groups, which was more marked in the group with PDA ligation at 24 hours. These data reflect expected pathophysiology since early PDA ligation exerts additional hemodynamic demand on the heart. In conclusion, the premature primate is able to mount a significant and severity-dependent endocrine response to stress.
KW - Patent ductus arteriosus
KW - hormonal response to surgery
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U2 - 10.1016/0022-3468(93)90342-I
DO - 10.1016/0022-3468(93)90342-I
M3 - Article
C2 - 8331518
AN - SCOPUS:0027211010
VL - 28
SP - 844
EP - 846
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 6
ER -