Why the study?
Does major surgery alter the distribution volume and biological half-life of cortisol in normal subjects?
Does major surgery alter the distribution volume and biological half-life of cortisol in normal subjects?
Major surgery significantly increases the volume of distribution and metabolic clearance rate of cortisol, invalidating secretion calculations based solely on plasma cortisol values.
Altered cortisol kinetics during surgery caution against plasma-only secretion estimates; leaves open effects on perioperative replacement dosing.
The volume of distribution, metabolic clearance rate and biological half life of radio-cortisol were measured before, during, and after major surgery by means of repeated single injections of 14C or 3H labeled cortisol in 4 normal subjects. Biological half life of cortisol was approximately unaltered during the study. The calculated volume of distribution and metabolic clearance rate increased an average of 175% and 130%, respectively, during and after surgery. It is concluded that calculation of the amount of cortisol secreted during and after major surgery, based upon plasma cortisol values and the assumption of an unaltered volume of distribution and biological half life is invalidated by apparent major alterations in the volume of distribution and minor alterations in biological half life. The data support that cortisol secretion is maximal during major surgical stress.
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Kehlet et al. (1973) studied this question.
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