Taşar Serçin, Dikmen Nur, Bulut İsmail, Haskılıç Yunus Emre, Saç Rukiye Ünsal, Şenes Mehmet, Taşar Medine Ayşin, Taşar Mehmet
Department of Pediatrics, Ankara Education and Research Hospital, Ankara, Turkey.
Department of Pediatric Cardiovascular Surgery, Dr.Sami Ulus Maternity, Child Health and Disease Education and Research Hospital, Ankara, Turkey.
Cardiol Young. 2023 Jan;33(1):106-112. doi: 10.1017/S1047951122001081. Epub 2022 Apr 1.
This study aimed to provide baseline information on the potential role of salivary cortisol in reflecting the stress response in children undergoing congenital heart surgery.
Children underwent congenital cardiac surgery, aged between one and seventeen years were included. Saliva samples were collected pre- and postoperatively by the health caregiver immediately after the children woke up (07:00-09:00 am) and at 06:00 pm in the evening. Salivary cortisol levels were compared with the reference index values from a large database.
Median baseline preoperative morning salivary cortisol levels were significantly lower than the reference values in both < 5-year-old females (p = 0.01) and males (p = 0.04) and in males between 11 and 20 years of age (p = 0.01). Median baseline preoperative evening salivary cortisol levels were significantly higher than the reference value in < 5-year-old females (p = 0.01) and between 5 and 10 years of age (p = 0.04) and in between 11- and20-year-old males (p = 0.01). Median postoperative morning salivary cortisol levels were significantly lower than the reference value in both < 5-year-old females (p = 0.01) and males (p = 0.04) and females between 5 and 10 year of age (p = 0.04). Median postoperative evening salivary cortisol levels were significantly higher than the reference value in < 5-year-old females (p = 0.01) and between 5- and 10-year-old females (p = 0.04).
Diurnal variability of salivary cortisol levels in children undergoing congenital heart surgery may be different from normal reference values both in preoperative and postoperative periods that can be a predictive indicator of anxiety on pre- and postoperative period for children that undergoing cardiac surgery.
本研究旨在提供有关唾液皮质醇在反映先天性心脏病手术患儿应激反应方面潜在作用的基线信息。
纳入年龄在1至17岁之间接受先天性心脏手术的儿童。唾液样本由医护人员在患儿术后醒来后立即（上午7:00 - 9:00）以及晚上6:00收集。将唾液皮质醇水平与来自大型数据库的参考指标值进行比较。
术前早晨唾液皮质醇水平中位数在5岁以下女性（p = 0.01）和男性（p = 0.04）以及11至20岁男性中（p = 0.01）均显著低于参考值。术前晚上唾液皮质醇水平中位数在5岁以下女性（p = 0.01）、5至10岁儿童（p = 0.04）以及11至20岁男性中（p = 0.01）显著高于参考值。术后早晨唾液皮质醇水平中位数在5岁以下女性（p = 0.01）和男性（p = 0.04）以及5至10岁女性中（p = 0.04）均显著低于参考值。术后晚上唾液皮质醇水平中位数在5岁以下女性（p = 0.01）和5至10岁女性中（p = 0.04）显著高于参考值。
先天性心脏病手术患儿唾液皮质醇水平的昼夜变化在术前和术后可能与正常参考值不同，这可能是心脏手术患儿术前和术后焦虑的预测指标。
