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Related Experiment Videos

Cardiopulmonary bypass and thyroid function: a "euthyroid sick syndrome".

F W Holland1, P S Brown, B D Weintraub

  • 1Surgery Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.

The Annals of Thoracic Surgery
|July 1, 1991
PubMed
Summary

Cardiopulmonary bypass significantly lowers active triiodothyronine (T3) and free T3 while increasing inactive reverse T3, mimicking the "euthyroid sick syndrome." This suggests T3 therapy may help prevent low cardiac output post-surgery.

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Area of Science:

  • Endocrinology
  • Cardiovascular Surgery

Background:

  • Cardiopulmonary bypass (CPB) is a critical procedure in cardiac surgery.
  • The impact of CPB on thyroid hormone metabolism is not fully understood.
  • Thyroid hormones play a vital role in cardiovascular function.

Purpose of the Study:

  • To investigate the effects of CPB on thyroid hormone and metabolite concentrations.
  • To determine if CPB induces a state similar to the
  • euthyroid sick syndrome
  • in patients undergoing cardiac surgery.

Main Methods:

  • Prospective study involving 14 patients undergoing CPB.
  • Serial blood sampling preoperatively, during CPB, and up to 24 hours postoperatively.
  • Measurement of thyroid-stimulating hormone, thyroid-binding globulin, thyroxine, triiodothyronine (T3), and reverse T3 using radioimmunoassay and equilibrium dialysis.

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Main Results:

  • Significant depression of total T3 and free T3 levels (up to 24 hours post-CPB).
  • Marked increase in reverse T3 levels postoperatively.
  • Decreased thyroid-binding globulin concentrations throughout the study period.
  • Normal levels of thyroid-stimulating hormone, thyroxine, and free thyroxine were maintained.

Conclusions:

  • CPB induces a metabolic state resembling the "euthyroid sick syndrome" characterized by low T3 and elevated reverse T3.
  • These findings support further investigation into intravenous T3 administration for preventing or treating low cardiac output syndrome after CPB.