Plasma corticotropin (ACTH), growth hormone (GH), and 11-OHCS (hydroxycorticosteroid) response during surgery.

Abstract Plasma concentrations of corticotropin (ACTH), growth hormone (GH), and 11-OHCS (hydroxycorticosteroid) were determined every 15 minutes in 7 patients during major surgery. GH and 11-OHCS were determined by radioimmunoassay and fluorometry, respectively. ACTH was measured by radioimmunoassay using an antiserum reactive to 1 to 24 amino acid sequence of ACTH molecule, with which the data were consistent with the known deviation of pituitary-adrenal function in patients with pituitary-adrenal dysfunction. Plasma ACTH concentration fluctuates rather rapidly during surgical operation. The first peak was noticed between 15 and 45 minutes after incision. The maximum ACTH concentration of these patients ranged from 110 to 1,000 pg. per milliliter with a mean of 596 pg. per milliliter. Plasma 11-OHCS could not fully reflect ACTH concentration in plasma. The first peak of GH appeared 15 to 45 minutes behind that of ACTH in 6 of 7 patients examined; the secretion patterns of these hormones were quite different, suggesting the dichotomy in the regulatory mechanism of these hormones during surgical stress.