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Clinical review: thyroid hormone replacement in children after cardiac surgery--is it worth a try?

Nikolaus A Haas1, Christoph K Camphausen, Deniz Kececioglu

  • 1Paediatric Cardiac Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia. nikhaas@hdz-nrw.de

Critical Care (London, England)
|May 25, 2006
PubMed

Insights

Sick euthyroid syndrome (SES) is common in pediatric cardiac surgery patients after cardiopulmonary bypass. Thyroid hormone replacement therapy may improve outcomes, but research is conflicting.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pediatrics

Background:

  • Cardiopulmonary bypass in cardiac surgery triggers a systemic inflammatory response.
  • This response can lead to sick euthyroid syndrome (SES), a thyroid abnormality without primary thyroid disease.
  • SES is particularly noted in neonates and small children undergoing prolonged bypass procedures.

Purpose of the Study:

  • To review the literature on SES development in pediatric cardiac surgery patients.
  • To analyze existing data on thyroid hormone replacement therapy in this population.
  • To summarize findings and provide recommendations regarding treatment.

Main Methods:

  • Literature review of studies on SES in pediatric cardiac surgery.
  • Analysis of thyroid hormone replacement therapy trials in affected children.
  • Synthesis of evidence to inform clinical recommendations.

Main Results:

  • Conflicting results exist regarding the efficacy of thyroid hormone replacement therapy.
  • SES is associated with increased postoperative morbidity and mortality in this vulnerable group.
  • Further research is needed to clarify optimal therapeutic strategies.

Conclusions:

  • Thyroid hormone replacement therapy is a potential intervention for postoperative SES in pediatric cardiac surgery.
  • Evidence is currently insufficient to make definitive recommendations due to conflicting study results.
  • More high-quality research is required to establish the role of hormone supplementation in improving outcomes.

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