| Cardiovascular effects of oral tri-iodothyronine in patients undergoing valvular cardiac surgery. |
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Ji Yeon Lee, Hee Yeon Park, Bum Su Kim, Young Lan Kwak |
1Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon Medical School, Incheon, Korea.
2Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ylkwak@yuhs.ac |
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| Abstract |
BACKGROUND
Cardiopulmonary bypass produces a state of functional hypothyroidism characterized by low levels of circulating tri-iodothyronine (T3). Theoretically, supplementing T3 should result in improved hemodynamics as well as patients' outcome. The aim of the present study was to determine whether pretreatment with single oral T3 could prevent serum T3 reduction, and improve hemodynamics and clinical outcome.
METHODS
Forty-seven patients undergoing valvular heart surgery were included in the study. Patients were randomly assigned into two groups (T = T group; C = control group) the day before surgery and received single oral T3 40 microg or placebo before operation. Blood samples were collected for determination of serum levels of total T3, T4 and TSH before administration of oral T3 or placebo (baseline), 1, 6 and 18 hour after weaning of cardiopulmonary bypass.
Hemodynamic parameters and medication were recorded during the intraoperative period and throughout the first 24 h after arrival at the intensive care unit.
RESULTS
T3 levels were significantly higher in the T group 1 hr after weaning of cardiopulmonary bypass. T3 levels in the T group were all maintained within the normal range throughout the study period, whereas it was decreased to below normal level in the C group at 18 hr after weaning of cardiopulmonary bypass. In the T group, vasoactive agent requirements were reduced during and after cardiopulmonary bypass.
CONCLUSIONS
Pretreatment with single oral T3 prevented the reduction in T3 level after valvular heart surgery, with subsequent reduction in vasoactive agent requirement. |
| Key Words:
Cardiopulmonary bypass; Tri-iodothyronine; Valvular heart surgery |
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