ACUTE HYPOFERREMIA FOLLOWING CARDIAC-SURGERY

Serum Fe concentration, temperature, white blood count, and weight were reviewed throughout the hospitalization in 13 patients who underwent open-heart surgery for valvular replacement and 43 who required coronary artery bypass grafting. Serum Fe concentration climbed from an admission average of 91.1 .mu.g/100 ml .+-. 44.0 to 124.3 .mu.g/ml .+-. 40 within 20 h of surgery and then rapidly dropped to 29.0 .mu.g/100 ml .+-. 20.1 within 18 h of surgery. Serum Fe levels remained < 1/2 of admission values throughout hospitalization (2 wk). Temperature increased from 98.6.degree. F .+-. 0.5 before surgery to 101.1.degree. F .+-. 1.0 the night of surgery, remaining mildly elevated until 14 days following surgery. White blood count jumped from admission levels of 7.1 .times. 103 .+-. 1.8 to 15.2 .times. 103 .+-. 5.8 within 6 h of operation. Preoperative levels were again reached 5 days following operation. Patient weights averaged 73.9 kg .+-. 14.6 on admission increasing to 78.6 kg .+-. 10.4 on the day following surgery. Only hypoferremia persisted beyond discharge into the anabolic phase of recovery. Stress-induced hypoferremia following operation runs a different time course than fever, leukocytosis, or weight gain and thus must be mediated by a different mechanism.