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The Annals of Thoracic Surgery, Vol 36, 306-313, Copyright © 1983 by The Society of Thoracic Surgeons
DJ Chambers, J Dunham, MV Braimbridge, B Slavin, J Quiney and J Chayen
Normal myocardial function is dependent on the metabolic balance of a
number of electrolytes and hormones. The calcium ion plays a major role in
muscle contraction and is rigorously controlled within narrow limits.
Open-heart surgery imposes metabolic disturbances on both electrolytes and
hormones, especially ionized calcium. Normally, ionized calcium levels are
controlled by parathyroid hormone with a negative feedback from the ionized
calcium controlling the system, but the results from this study suggest
that during open-heart procedures, ionized calcium does not impose its
normal negative feedback on bioactive parathyroid hormone secretion. The
low blood pH levels that occurred during the operative conditions of the
patients studied and the level of hypothermia imposed on the circulating
blood during cardiopulmonary bypass appeared to influence the control of
parathyroid hormone secretion, causing high levels of hormone to be
secreted during this period.
ARTICLES
The effect of ionized calcium, pH, and temperature on bioactive parathyroid hormone during and after open-heart operations
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