Cortisol and antidiuretic hormone responses to stress in cardiac surgical patients

Can Anaesth Soc J. 1981 Jul;28(4):334-8. doi: 10.1007/BF03007799.


The hormonal responses to anaesthesia and cardiac surgery were studied in patients undergoing valve or coronary bypass surgery. Marked increases in antidiuretic hormone levels as a result of surgical stress were seen, and were of approximately equal magnitude in both groups. Although both groups also showed marked increases in plasma cortisol levels in response to operations, this response appeared to be relatively blunted in valve surgery patients, especially at the end of operation and in the intensive care unit. This blunted cortisol response may be a manifestation of exhaustion of adrenocortical reserves in valvular surgical patients whose sympathoadrenal system has already been chronically stimulated by a low output state. The important role of the neuroendocrine system in maintaining homeostasis postoperatively has long been recognized; this relative cortisol deficiency may be aetiologically related to poor postoperative recovery in critically ill valvular surgery patients.

MeSH terms

  • Coronary Disease / blood
  • Coronary Disease / physiopathology
  • Coronary Disease / surgery*
  • Heart Valve Diseases / blood
  • Heart Valve Diseases / physiopathology
  • Heart Valve Diseases / surgery*
  • Hemodynamics
  • Humans
  • Hydrocortisone / blood*
  • Middle Aged
  • Stress, Physiological / blood*
  • Stress, Physiological / physiopathology
  • Vasopressins / blood*


  • Vasopressins
  • Hydrocortisone