Abstract
In infants and children undergoing cardiopulmonary bypass for congenital heart disease surgery, thyroid hormone (TH) levels drop immediately after bypass and reach a nadir 24–48 h postoperatively. A small number of studies have been published evaluating triiodothyronine (T3) supplementation in this population. T3 supplementation appears to be safe and to improve some measures of recovery; however, no published studies have clearly shown a clinical benefit for this treatment as these investigations have been significantly limited by low patient numbers. The Triiodothyronine for Infants and Children Undergoing Cardiopulmonary Bypass (TRICC) study, the largest pediatric study on T3 supplementation, recently completed enrollment but a full evaluation of the results has yet to be published. The TRICC study should provide additional, important safety and efficacy data.
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References
Klein I, Ojamaa K (2001) Thyroid hormone and the cardiovascular system. N Engl J Med 344:501–509
Novitzky D, Human PA, Cooper DK (1988) Inotropic effect of triiodothyronine following myocardial ischemia and cardiopulmonary bypass: an experimental study in pigs. Ann Thorac Surg 45:50–55
Park KW, Dai HB, Ojamaa K et al (1997) The direct vasomotor effect of thyroid hormones on rat skeletal muscle resistance arteries. Anesth Analg 85:734–738
Bennett-Guerrero E, Jimenez JL, White WD et al (1996) Cardiovascular effects of intravenous triiodothyronine in patients undergoing coronary artery bypass graft surgery. A randomized double-blind placebo-controlled trial. Duke T3 study group. JAMA 275:687–692
Klemperer JD, Klein I, Gomez M et al (1995) Thyroid hormone treatment after coronary-artery bypass surgery. N Engl J Med 333:1522–1527
Bettendorf M, Schmidt KG, Grulich-Henn J et al (2000) Triiodothyronine treatment in children after cardiac surgery: a double-blind randomised placebo-controlled study. Lancet 356:529–534
Portman MA, Fearneyhough C, Ning XH et al (2000) Triiodothyronine repletion in infants during cardiopulmonary bypass for congenital heart disease. J Thorac Cardiovasc Surg 120:604–608
Dyke CM, Ding M, Abd-Elfattah AS et al (1993) Effects of triiodothyronine supplementation after myocardial ischemia. Ann Thorac Surg 56:215–222
Mullis-Jansson SL, Argenziano M, Corwin S et al (1999) A randomized double-blind study of the effect of triiodothyronine on cardiac function and morbidity after coronary bypass surgery. J Thorac Cardiovasc Surg 117:1128–1134
Bettendorf M, Schmidt KG, Tiefenbacher U et al (1997) Transient secondary hypothyroidism in children after cardiac surgery. Pediatr Res 41:375–379
Dagan O, Vidne B, Josefsberg Z et al (2006) Relationship between changes in thyroid hormone level and severity of the postoperative course in neonates undergoing open-heart surgery. Paediatr Anaesth 16:538–542
Chowdhury D, Ojamaa K, Parnell VA et al (2001) A prospective, randomized clinical study of thyroid hormone treatment after operations for complex congenital heart disease. J Thorac Cardiovasc Surg 122:1023–1025
Mackie AS, Booth KL, Newburger JW et al (2005) A randomized double-blind placebo-controlled pilot trial of triiodothyronine in neonatal heart surgery. J Thorac Cardiovasc Surg 130:810–816
Mainwaring RD, Nelson JC (2002) Supplementation of thyroid hormone in children undergoing cardiac surgery. Cardiol Young 12:211–217
Mainwaring RD, Lamberti JJ, Nelson JC et al (2007) Effects of triiodothyronine supplementation following modified Fontan procedure. Cardiol Young 7:194–200
Mainwaring RD, Lamberti JJ, Carter TL Jr et al (1994) Reduction in triiodothyronine levels following modified Fontan procedure. J Card Surg 9:322–331
Brogan TV, Bratton SL, Lynn AM (1997) Thyroid function in infants following cardiac surgery: comparative effects of iodinated and noniodinated topical antiseptics. Crit Care Med 25:1583–1587
Mainwaring RD, Capparelli E, Schell K et al (2000) Pharmacokinetic evaluation of triiodothyronine supplementation in children after modified Fontan procedure. Circulation 101:1423–1429
Mainwaring RD, Healy RM, Meier FA et al (2001) Reduction in levels of triiodothyronine following the first stage of the Norwood reconstruction for hypoplastic left heart syndrome. Cardiol Young 11:295–300
Mitchell IM, Pollock JC, Jamieson MP et al (1992) The effects of cardiopulmonary bypass on thyroid function in infants weighing less than five kilograms. J Thorac Cardiovasc Surg 103:800–805
Brabant G, Brabant A, Ranft U et al (1987) Circadian and pulsatile thyrotropin secretion in euthyroid man under the influence of thyroid hormone and glucocorticoid administration. J Clin Endocrinol Metab 65:83–88
Van den Berghe G, de Zegher F, Lauwers P (1994) Dopamine suppresses pituitary function in infants and children. Crit Care Med 22:1747–1753
Dimmick S, Badawi N, Randell T (2004) Thyroid hormone supplementation for the prevention of morbidity and mortality in infants undergoing cardiac surgery. Cochrane Database Syst Rev: CD004220
van der Poll T, Romijn JA, Wiersinga WM et al (1990) Tumor necrosis factor: a putative mediator of the sick euthyroid syndrome in man. J Clin Endocrinol Metab 71:1567–1572
Butler J, Chong GL, Baigrie RJ et al (1992) Cytokine responses to cardiopulmonary bypass with membrane and bubble oxygenation. Ann Thorac Surg 53:833–838
Portman MA, Fearneyhough C, Karl TR et al (2004) The Triiodothyronine for Infants and Children Undergoing Cardiopulmonary Bypass (TRICC) study: design and rationale. Am Heart J 148:393–398
Danzi S, Klein I, Portman MA (2005) Effect of triiodothyronine on gene transcription during cardiopulmonary bypass in infants with ventricular septal defect. Am J Cardiol 95:787–789
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Olson, A.K., Portman, M.A. (2009). Thyroid Hormone Supplementation for Infants and Children Undergoing Cardiopulmonary Bypass for Cardiac Surgery. In: Iervasi, G., Pingitore, A. (eds) Thyroid and Heart Failure. Springer, Milano. https://doi.org/10.1007/978-88-470-1143-4_21
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DOI: https://doi.org/10.1007/978-88-470-1143-4_21
Publisher Name: Springer, Milano
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