Surgical Stress and Neuroendocrine Responses in Infants and Children

Rosendahl, W; Schulz, U; Teufel, T.; Brenndorf, C Irtel von; Gupta, D.

doi:10.1515/jpem.1995.8.3.187

Cited by 40 publications

(33 citation statements)

References 25 publications

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“…Some authors believe that rhythmicity starts as early as within the 2nd week of life [15,[18][19][20][21][22][23], while others state that the circadian rhythm of cortisol plasma levels is only present after 9 months of life [16]. In our study, no circadian rhythmicity was present in the whole group of 119 infants during the two days of the study period.…”

Section: B a Discussioncontrasting

confidence: 50%

See 1 more Smart Citation

Cortisol and 17-Hydroxyprogesterone Levels in Saliva of Healthy Neonates

Klug

Dressendörfer²,

Strasburger³

et al. 2000

Neonatology

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The measurement of cortisol and 17-hydroxyprogesterone (17-OHP) in saliva has become a reliable tool for both the scientist and the clinician for studying adrenal cortical function in the adult and the older child. We have now established in parallel normative data for salivary cortisol and 17-OHP levels in healthy neonates. We have asked whether or not there is a circadian rhythm of cortisol and 17-OHP saliva levels in neonates. Furthermore, we have asked whether salivary hormone levels correlated with auxologic and clinical data and time of sampling. Cortisol and 17-OHP levels in saliva samples from 119 healthy neonates (55 girls, 64 boys) were measured using in-house time-resolved fluorescent immunoassays. Saliva samples were obtained using a saliva collecting tube three times a day on the first or second day of life. Gender and gestational age did not influence salivary cortisol and 17-OHP levels. No significant circadian rhythm of salivary hormone levels was detected in this group of newborns. However, body mass index, arterial cord blood pH and time of saliva sampling significantly influenced salivary hormone levels. In conclusion, measurement of cortisol and 17-OHP in saliva is feasible in healthy neonates. The existence of normative data forms the basis for future studies on pathophysiologic states in the newborn period.

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Section: B a Discussioncontrasting

confidence: 50%

“…0.001). We hypothesize that stress might contribute to high cortisol production of the neonate around birth and during delivery [15,16]. As a consequence, high cortisol saliva levels are present at birth and shortly thereafter.…”

Section: B a Discussionmentioning

confidence: 99%

Cortisol and 17-Hydroxyprogesterone Levels in Saliva of Healthy Neonates

Klug

Dressendörfer²,

Strasburger³

et al. 2000

Neonatology

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“…Surgical stress and anesthesia result in various metabolic and endocrine disturbances, and may lead to generalized immune suppression [3][4][5][6] . Neuraxial anesthesia (NA), including spinal and/or epidural anesthesia, reduces the surgical stress response 7,8 .…”

Section: Introductionmentioning

confidence: 99%

Neuraxial Anesthesia Decreases Postoperative Systemic Infection Risk Compared With General Anesthesia in Knee Arthroplasty

Liu¹,

Ma²,

Elkassabany³

et al. 2014

Survey of Anesthesiology

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Background-Surgical stress has been previously shown to result in immune disturbance. Neuraxial anesthesia (NA) has been long hypothesized to blunt undesired surgical insults, and thus limit immune compromise and improve surgical outcomes. We hypothesized that neuraxial anesthesia would decrease postoperative infectious complications compared to general anesthesia among knee arthroplasty patients.

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“…While some authors defend that acute hypotension can stimulate AVP release since arterial pressure drops are often seen during and after anesthetic/surgical procedures [8], others disagree as they had not found a significant correlation between plasma AVP concentrations and arterial pressure levels at different times of surgical procedures [9]. So, despite the well documented plasmatic AVP increase during major surgical procedures, the subjacent mechanisms responsible for this exceptional AVP releasing to remain incompletely understood [5,10].…”

Section: Introductionmentioning

confidence: 99%

Vasopressina plasmática em pacientes submetidos à correção de aneurisma de aorta infrarrenal

Carvalho¹,

Guillaumon²,

Cintra³

et al. 2011

Rev Bras Cir Cardiovasc

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Objectives: To evaluate plasmatic arginine vasopressin (AVP) levels in patients undergoing scheduled conventional abdominal aortic aneurysm (AAA) repair.Methods: Plasmatic AVP concentrations were measured by radioimmunoassay in 22 non-consecutive adult patients undergoing infra-renal AAA repair. They were under combined general and epidural anesthesia at the following time frames: 1 -pre-operative (T0); 2 -2h (T1) and 6h (T2) after the surgical procedure; 3 -in the morning at the first (T3), second (T4) and third (T5) post-operative days. Some clinical and laboratory variables were also recorded.Results: The mean age of patients was 68±10 years; 17 were males. Plasmatic AVP (mean±SD; pg/mL) was within the normal range at T0 (1.4±0.7; baseline), increasing significantly at T1 (62.6±62.9; P<0.001) and at T2 (31.5±49.7; P<0.001), with a progressive fall, returning to basal levels at T5 (2.1±3.8; P=NS). Positive and statistically significant correlations were found between AVP and glycemia, serum lactate and white blood cells counts, but not with systemic arterial pressure or plasma osmolarity during the postoperative period.Conclusions: Considering that no correlations were found between AVP levels and hemodynamic or plasmatic osmolarity variations in AAA repair, it seems that stress response is mainly secondary to noxious stimulation mediated by the autonomic nervous system that is not completely blocked by anesthetics. Descriptors: Intensive care units. Cardiovascular abnormalities. Receptors, vasopressin. Resumo Objetivos: Avaliar os níveis plasmáticos de vasopressina (AVP) em pacientes submetidos à correção convencional de aneurisma de aorta abdominal (AAA).Métodos: A AVP plasmática foi mensurada por radioimunoensaio em 22 pacientes não-consecutivos submetidos à correção eletiva de AAA infrarrenal sob anestesia geral + epidural nos seguintes momentos: pré-operatório (T0); 2h (T1) e 6h (T2) após a cirurgia; e nas manhãs do primeiro (T3), segundo (T4) e terceiro (T5) dia pós-operatório (PO). Variáveis clínicas e laboratoriais de interesse também foram anotadas.Resultados: A média de idade dos pacientes foi de 68±10 anos, sendo 17 homens. A AVP plasmática (média±DP; pg/ mL) estava dentro de limites normais no T0 (1,4±0,7; basal), aumentando no T1 (62,6±62,9; P<0,001) e no T2 (31,5±49,7; P<0,001), e retornando aos valores basais no T5 (2,1±3,8; RBCCV 44205-1296

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Surgical Stress and Neuroendocrine Responses in Infants and Children

Cited by 40 publications

References 25 publications

Cortisol and 17-Hydroxyprogesterone Levels in Saliva of Healthy Neonates

Cortisol and 17-Hydroxyprogesterone Levels in Saliva of Healthy Neonates

Neuraxial Anesthesia Decreases Postoperative Systemic Infection Risk Compared With General Anesthesia in Knee Arthroplasty

Vasopressina plasmática em pacientes submetidos à correção de aneurisma de aorta infrarrenal

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