The Journal of Thoracic and Cardiovascular Surgery, Vol 75, 579-584, Copyright © 1978 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Comparative studies of pulsatile and nonpulsatile flow during cardiopulmonary bypass. III. Response of anterior pituitary gland to thyrotropin-releasing hormone
KM Taylor, GS Wright, WH Bain, PK Caves and GS Beastall
Previous studies have indicated that, during nonpulsatile cardiopulmonary
bypass, the anterior pituitary gland fails to respond to the tropic
stimulus of thyrotropin-releasing hormone (TRH). This is in contrast to the
normal response seen during closed cardiac and general surgical procedures.
The Stockert pulsatile pump system described in Part I has been employed in
a comparative study of TRH responses in 20 patients subjected to pulsatile
or nonpulsatile perfusion during open-heart surgery. In the nonpulsatile
group, a consistently subnormal response to TRH injection was again found.
In the pulsatile group, however, the pituitary response to TRH was normal
in nine patients out of 10. The quantitative difference between the groups
was statistically highly significant (p less than 0.005). These results
indicate that the subnormal pituitary function seen with nonpulsatile
bypass may be prevented by the use of pulsatile perfusion.