Advertisement

Thyroid Disease

  • Jennifer R. LydenEmail author
  • Jeanie C. Yoon
Chapter

Abstract

Disorders of the thyroid gland are common. Millions of Americans are living with subclinical or overt thyroid dysfunction, and physicians who provide perioperative care are frequently asked to assess surgical risk and assist in the management of patients with thyroid disease.

Thyroid hormone affects virtually every organ system in the body. In the perioperative period, the effects of thyroid imbalance range from clinically insignificant to shock and catastrophic multiorgan system failure. Despite the prevalence of thyroid dysfunction and its potential impact on surgical patients, there is a paucity of data examining surgical outcomes in those with thyroid disease.

Keywords

Thyroid Hormone Enteral Nutrition Thyroid Dysfunction Hypothyroid Patient Subclinical Hyperthyroidism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Brent GA. Mechanisms of thyroid hormone action. J Clin Invest. 2012;122(9):3035–43.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Vanderpump MP. The epidemiology of thyroid disease. Br Med Bull. 2011;99:39–51.CrossRefPubMedGoogle Scholar
  3. 3.
    Werner SC, Ingbar SH, Braverman LE, Utiger RD. Werner & Ingbar’s the thyroid: a fundamental and clinical text. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.Google Scholar
  4. 4.
    Taylor PN, Razvi S, Pearce SH, Dayan CM. Clinical review: a review of the clinical consequences of variation in thyroid function within the reference range. J Clin Endocrinol Metab. 2013;98(9):3562–71.CrossRefPubMedGoogle Scholar
  5. 5.
    Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988–1028.CrossRefPubMedGoogle Scholar
  6. 6.
    Schiff RL, Welsh GA. Perioperative evaluation and management of the patient with endocrine dysfunction. Med Clin North Am. 2003;87(1):175–92.CrossRefPubMedGoogle Scholar
  7. 7.
    Dickerson RN, Maish 3rd GO, Minard G, Brown RO. Clinical relevancy of the levothyroxine-continuous enteral nutrition interaction. Nutr Clin Pract. 2010;25(6):646–52.CrossRefPubMedGoogle Scholar
  8. 8.
    Manessis A, Lascher S, Bukberg P, et al. Quantifying amount of adsorption of levothyroxine by percutaneous endoscopic gastrostomy tubes. JPEN J Parenter Enteral Nutr. 2008;32(2):197–200.CrossRefPubMedGoogle Scholar
  9. 9.
    Weinberg AD, Brennan MD, Gorman CA, Marsh HM, O’Fallon WM. Outcome of anesthesia and surgery in hypothyroid patients. Arch Intern Med. 1983;143(5):893–7.CrossRefPubMedGoogle Scholar
  10. 10.
    Gualandro DM, Pinho C, et al. I guidelines for perioperative evaluation. Arq Bras Cardiol. 2007;89(6):210–37.CrossRefGoogle Scholar
  11. 11.
    Stathatos N, Wartofsky L. Perioperative management of patients with hypothyroidism. Endocrinol Metab Clin North Am. 2003;32(2):503–18.CrossRefPubMedGoogle Scholar
  12. 12.
    Graham GW, Unger BP, Coursin DB. Perioperative management of selected endocrine disorders. Int Anesthesiol Clin. 2000;38(4):31–67.CrossRefPubMedGoogle Scholar
  13. 13.
    Vanderpump MP, Tunbridge WM. Epidemiology and prevention of clinical and subclinical hypothyroidism. Thyroid. 2002;12(10):839–47.CrossRefPubMedGoogle Scholar
  14. 14.
    Murkin JM. Anesthesia and hypothyroidism: a review of thyroxine physiology, pharmacology, and anesthetic implications. Anesth Analg. 1982;61(4):371–83.CrossRefPubMedGoogle Scholar
  15. 15.
    Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med. 2007;22(4):224–31.CrossRefPubMedGoogle Scholar
  16. 16.
    Klubo-Gwiezdzinska J, Wartofsky L. Thyroid emergencies. Med Clin North Am. 2012;96(2):385–403.CrossRefPubMedGoogle Scholar
  17. 17.
    Wall CR. Myxedema coma: diagnosis and treatment. Am Fam Physician. 2000;62(11):2485–90.PubMedGoogle Scholar
  18. 18.
    Stockigt JR. Guidelines for diagnosis and monitoring of thyroid disease: nonthyroidal illness. Clin Chem. 1996;42(1):188–92.PubMedGoogle Scholar
  19. 19.
    Wartofsky L, Burman KD. Alterations in thyroid function in patients with systemic illness: the “euthyroid sick syndrome”. Endocr Rev. 1982;3(2):164–217.CrossRefPubMedGoogle Scholar
  20. 20.
    DeGroot LJ. "Non-thyroidal illness syndrome" is functional central hypothyroidism, and if severe, hormone replacement is appropriate in light of present knowledge. J Endocrinol Invest. 2003;26(12):1163–70.CrossRefPubMedGoogle Scholar
  21. 21.
    Adler SM, Wartofsky L. The nonthyroidal illness syndrome. Endocrinol Metab Clin North Am. 2007;36(3):657–672, vi.Google Scholar
  22. 22.
    Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116(15):1725–35.CrossRefPubMedGoogle Scholar
  23. 23.
    Myerowitz PD, Kamienski RW, Swanson DK, et al. Diagnosis and management of the hypothyroid patient with chest pain. J Thorac Cardiovasc Surg. 1983;86(1):57–60.PubMedGoogle Scholar
  24. 24.
    Drucker DJ, Burrow GN. Cardiovascular surgery in the hypothyroid patient. Arch Intern Med. 1985;145(9):1585–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Arlot S, Debussche X, Lalau JD, et al. Myxoedema coma: response of thyroid hormones with oral and intravenous high-dose L-thyroxine treatment. Intensive Care Med. 1991;17(1):16–8.CrossRefPubMedGoogle Scholar
  26. 26.
    Yamamoto T, Fukuyama J, Fujiyoshi A. Factors associated with mortality of myxedema coma: report of eight cases and literature survey. Thyroid. 1999;9(12):1167–74.CrossRefPubMedGoogle Scholar
  27. 27.
    Guden M, Akpinar B, Saggbas E, Sanisoglu I, Cakali E, Bayindir O. Effects of intravenous triiodothyronine during coronary artery bypass surgery. Asian Cardiovasc Thorac Ann. 2002;10(3):219–22.CrossRefPubMedGoogle Scholar
  28. 28.
    Hamilton MA, Stevenson LW, Fonarow GC, et al. Safety and hemodynamic effects of intravenous triiodothyronine in advanced congestive heart failure. Am J Cardiol. 1998;81(4):443–7.CrossRefPubMedGoogle Scholar
  29. 29.
    Ling XW. ea. Preoperative thyroid dysfunction predicts 30-day postoperative complications in elderly patients with hip fracture. Geriatric Orthopaedic Surgery and Rehabilitation. Geriatric Orthopaedic Surgery and. Rehabilitation. 2013;4(2):43–9.Google Scholar
  30. 30.
    Klein IDS. Thyroid disease and the heart. Circulation. 2007;116(15):1725–35.CrossRefPubMedGoogle Scholar
  31. 31.
    Sawin CT, et al. Low serum thyrotropic concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249–52.CrossRefPubMedGoogle Scholar
  32. 32.
    Sawin CTGA, Wolf PA, Belanger AJ, Baker E, Bacharach P, Wilson PW, Benjamin EJ, D’Agostino RB. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med. 1994;331:1249–52.CrossRefPubMedGoogle Scholar
  33. 33.
    Cappola ARFL, Arnold AM, Danese MD, Kuller LH, Burke GL, Tracy RP, Ladenson PW. Thyroid status, cardiovascular risk, and mortality in older adults. JAMA. 2006;2006(295):1033–41.CrossRefGoogle Scholar
  34. 34.
    Adlerberth ASG, Hasselgren PO. The selective beta 1-blocking agent metoprolol compared with antithyroid drug and thyroxine as preoperative treatment of patients with hyperthyroidism. Results from a prospective, randomized study. Ann Surg. 1987;205(2):182.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Ka W. Thyrotoxicosis and the heart. N Engl J Med. 1992;372(2):94.Google Scholar
  36. 36.
    Frost LVP, Mosekilde L. Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study. Arch Intern Med. 2004;164(15):1675.CrossRefPubMedGoogle Scholar
  37. 37.
    Mercé JFS, Oltra C, Sanz E, Vendrell J, Simón I, Camprubí M, Bardají A, Ridao C. Cardiovascular abnormalities in hyperthyroidism: a prospective Doppler echocardiographic study. Am J Med. 2005;118(2):126.CrossRefPubMedGoogle Scholar
  38. 38.
    Siu CW, Zhang XH, Yung C, Kung AW, Lau CP, Tse HF. Hemodynamic changes in hyperthyroidism-related pulmonary hypertension: a prospective echocardiographic study. J Clin Endocrinol Metab. 2007;92(5):1736.CrossRefPubMedGoogle Scholar
  39. 39.
    Bahn Chair RS, Burch HB, Cooper DS, Garber JR, Greenlee MC, Klein I, Laurberg P, McDougall IR, Montori VM, Rivkees SA, Ross DS, Sosa JA, Stan MN, American Thyroid Association, American Association of Clinical Endocrinologists. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid. 2011;21(6):593.CrossRefPubMedGoogle Scholar
  40. 40.
    Panzer C, Beazley R, Braverman L. Rapid preoperative preparation for severe hyperthyroid Graves’. J Clin Endocrinol Metab. 2004;89(5):2142.CrossRefPubMedGoogle Scholar
  41. 41.
    Das G, Krieger M. Treatment of thyrotoxic storm with intravenous administration of propranolol. Ann Intern Med. 1969;70(5):985.CrossRefPubMedGoogle Scholar
  42. 42.
    Ross DS. Iodinated radiocontrast agents in the treatment of hyperthyroidism. UpToDate 2013.Google Scholar
  43. 43.
    Burch HBWL. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22(2):263.PubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Division of General Internal Medicine, Department of MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations