Skip to main content
SpringerLink
Log in

Serum levels of gastric-acid-stimulating factors in children undergoing open heart surgery

  • Pediatric Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

Purpose

Upper gastrointestinal (GI) bleeding is a feared consequence of open heart surgery in children. Increased gastric acid secretion is a known key factor in the pathogenesis of gastritis and upper intestinal ulcerations. The aim of this study is to evaluate the serum kinetics of acid-stimulating factors and associated perioperative parameters after heart surgery in children.

Methods

Fifteen pediatric patients after open heart surgery and 15 children with cardiac catheterization were included in this study. Serum levels of gastrin, histidine, alanine, and tryptophan were analyzed before and up to 26 h after surgery.

Results

In the postoperative period there was a significant elevation of gastrin with a peak at 4 h after surgery. Serum histidine was increased significantly immediately after surgery only in patients undergoing heart surgery with cardioplegia. No association of gastrin and histidine elevation with ischemia, perfusion time or lactate was observed.

Conclusion

Factors that are responsible for postoperative gastrin elevation still have to be determined. Circumstances of extracorporeal circulation (ECC) in low-risk patients most likely do not lead to relevant elevation of amino acids with acid-stimulatory effect in our study population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Behrens R, Hofbeck M, Singer H, Scharf J, Rupprecht T (1994) Frequency of stress lesions of the upper gastrointestinal tract in paediatric patients after cardiac surgery: effect of prophylaxis. Br Heart J 72:186–189

    Article  PubMed  CAS  Google Scholar 

  2. Richie WP Jr (1975) Acute gastric mucosal damage induced by bile salts, acid, and ischemia. Gastroenterology 68:699–707

    Google Scholar 

  3. Schubert ML (2005) Gastric secretion. Curr Opin Gastroenterol 21:636–643

    Article  PubMed  Google Scholar 

  4. Busque SM, Kerstetter JE, Geibel JP, Insogna K (2005) L-Type amino acids stimulate gastric acid secretion by activation of the calcium-sensing receptor in parietal cells. Am J Physiol Gastrointest Liver Physiol 289:664–669

    Google Scholar 

  5. Konturek SJ, Tasler J, Cieszkowski M, Jaworek J (1978) Comparison of intravenous amino acids in the stimulation of gastric secretion. Gastroenterology 75:817–824

    PubMed  CAS  Google Scholar 

  6. Moazam F, Kirby WJ, Rodgers BM, McGuigan JE (1984) Physiology of serum gastrin production in neonates and infants. Ann Surg 199:389–392

    Article  PubMed  CAS  Google Scholar 

  7. Christenson JT, Schmuziger M, Maurice J, Simonet F, Velebit V (1994) Postoperative visceral hypotension the common cause for gastrointestinal complications after cardiac surgery. Thoracic Cardiovasc Surg 42:152–157

    Article  CAS  Google Scholar 

  8. van der Voort PH, Zandstra DF (2000) Pathogenesis, risk factors, and incidence of upper gastrointestinal bleeding after cardiac surgery: is specific prophylaxis in routine bypass procedures needed? J Cardiothoracic Vasc Anesth Vol 14:293–299

    Article  Google Scholar 

  9. Kitano M, Bernsand M, Kishimoto Y, Norlén P, Håkanson R, Haenuki Y, Kudo M, Hasegawa J (2005) Ischemia of rat stomach mobilizes ECL cell histamine. Am J Physiol Gastrointest Liver Physiol 288:G1084–G1090

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Kinder- und Jugendklinik, Universitätsklinikum Erlangen, Loschgestrasse 15, 91054, Erlangen, Germany

    Christian Breuer, Manfred Rauh & Henrik Köhler

  2. Abteilung für Kinderkardiologie, Universitätsklinikum Erlangen, Erlangen, Germany

    Christian Breuer, Stefan Zink, Andreas Koch & Sven Dittrich

  3. Klinik für Herzchirurgie, Universitätsklinikum Erlangen, Erlangen, Germany

    Michael Weyand

Authors
  1. Christian Breuer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Manfred Rauh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stefan Zink
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andreas Koch
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael Weyand
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sven Dittrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Henrik Köhler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Henrik Köhler.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Breuer, C., Rauh, M., Zink, S. et al. Serum levels of gastric-acid-stimulating factors in children undergoing open heart surgery. Intensive Care Med 35, 1619–1622 (2009). https://doi.org/10.1007/s00134-009-1543-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00134-009-1543-z

Keywords

Search

Navigation