DYNAMICS OF CORTISOL LEVEL DURING ANESTHESIA OF CARDIOSURGERY UNDER CARDIOPULMONARY BYPASS
Objective. The aim of our research was to define the dynamic of the cortisol level in patients in the perioperative period during cardiac surgery. Methods. A prospective nonrandomized observational study was carried out, which included 30 cardiac surgery patients. The age of the patients ranged from 49 to 67 years (64.0 (59.56; 33.25) years), body mass index - 29.05 (25.56; 33.25) kg/m². All patients underwent cardiac surgery under cardiopulmonary bypass. All patients underwent blood sampling at the following stages: stage 1 - the patient was on an operation table, catheterization of the peripheral vein, intravenous blood sampling; stage 2 - the patient is on the operating table, before being connected to the cardiopulmonary bypass; stage 3 - the end of the operation, suturing skin; stage 4 - the patient is in the intensive care unit, 1-3 hours after the operation; stage 5 - 17-20 hours later after the operative intervention. The quantitative determination of cortisol in the blood serum was carried out by the immunochemical method using the apparatus Architect plus i10000sr (Abbott, USA). Results. In stage 1, the cortisol level was 8.5 (6.3; 10.4) mcg/dl; at stage 2 - 11.0 (5.1; 14.3) mcg/dl; when suturing the skin - 28.4 (16.6; 36.5) mcg/dl; after 1-3 hours after the operation - 18.55 (14.6; 23.5) mcg/dl; on the next day - 13.2 (8.0; 19.9) mcg/dl. We also revealed a reliable difference in the level of cortisol in the serum at stages 3 and 5, depending almost on the inclusion of prednisolone in the composition of the primary solution. Conclusion. Determination of the level of cortisol should be used as a component of anesthetic monitoring during cardiac surgery. What this paper adds The control of the level of cortisol in the blood serum of patients as an additional method of anesthetic monitoring in the perioperative period during cardiac surgery has been proposed to use. It was found that the level of cortisol before the start of surgery was 8.5 (6.3; 10.4) mcg/dl, and the maximum level was detected at the stage of suturing the skin - 28.4 (16.6; 36.5) mcg/dl. Determination of cortisol levels should be used as a component of anesthetic monitoring in cardiac surgery.