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British Journal of Anaesthesia, 1976, Vol. 48, No. 4 355-364
© 1976 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

THE ADRENERGIC RESPONSE TO SURGERY INVOLVING CARDIOPULMONARY BYPASS, AS MEASURED BY PLASMA AND URINARY CATECHOLAMINE CONCENTRATIONS

I. P. HINE, M.R.C.S., L.R.C.P., F.F.A.R.C.S. (ENG.)&, W. G. WOOD, PH.D.*, R. W. MAINWARING-BURTON, B.SC., M. J. BUTLER, F.R.C.S.+, M. H. IRVING, F.R.C.S.{ddagger} and B. BOOKER, A.I.M.L.T.J

Department of Anaesthesia
Surgical Professorial Unit
Department of Chemical Pathology; The Royal Hospital of St Bartholomew West Smithfield, London ECIA 7BE.

Plasma and urinary catecholamine concentrations have been measured in 13 patients undergoing cardiac surgery involving cardiopulmonary bypass. The large and progressive increase in plasma catecholamines during bypass reported in previous studies has not been confirmed, and this may be a result of improvements in surgical, anaesthetic and perfusion techniques. The interpretation of urinary findings was complicated by the finding of a positive correlation between catecholamine excretion and urine flow-rate. The findings suggest the need to modify current concepts of the adrenergic response to cardiac surgery and bypass, and question the validity of measuring the urinary catecholamine concentration as an index of stress in these circumstances.

&County Hospital, Hereford HR1 2ER.

*Institut fiir Klinische Chemie und PathoBiochemie der Technischen Universitat, 8000 Mlinchen 80, Ismaninger Strasse 22, B.R.D.

+Surgical Division, Faculty of Medicine, University of Southampton, Fanshawe Street, Southampton SO9 4PE.

{ddagger}Department of Surgery, University of Manchester, Hope Hospital, Eccles Old Road, Salford M6 8HD.


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