Perioperative Management Endocrine Problems in Pediatric Cardiac Surgical Patients

Acute physical or emotional stresses are the most important activators of the hypothalamic–pituitary–adrenal (HPA) axis (Antoni 1986; Aguilera 1994; Thomason et al. 1999). Surgery is one the most potent activators of the axis. The degree of activeness depends on factors such as type of the surgery and the anesthetic agents used during the procedure (Chernow et al. 1987; Jabbour 2001; Bromberg et al. 1991). ... The level of cortisol changed during both major and minor surgeries. It fell initially after premedication and rose rapidly ...