Related Experiment Video
Updated: Mar 7, 2026
Delivery of Cardioactive Therapeutics in a Porcine Myocardial Infarction Model
Published on: February 10, 2023
Oral Triiodothyronine for Infants and Children Undergoing Cardiopulmonary Bypass
Eva M Marwali1, Cindy E Boom1, Novik Budiwardhana1
1Pediatric Cardiac Intensive Care and Anesthesiology Division, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.
Insights
Oral triiodothyronine (T3) supplementation may reduce extubation time in pediatric patients after heart surgery. This safe and inexpensive treatment showed particular benefit in infants under 5 months old.
Area of Science:
- Pediatric Cardiology
- Cardiothoracic Surgery
- Endocrinology
Background:
- Evaluating the efficacy and safety of oral triiodothyronine (T3) in pediatric patients undergoing cardiopulmonary bypass.
- Focus on Indonesian population undergoing congenital heart disease operations.
Purpose of the Study:
- To assess the impact of oral T3 supplementation on extubation time in infants and children post-cardiac surgery.
- To determine the safety profile of T3 administration in this vulnerable patient group.
Main Methods:
- Single-center, randomized, double-blind, placebo-controlled trial.
- Participants: Children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass.
- Intervention: Oral T3 (1 μg/kg) or placebo every 6 hours for 60 hours post-anesthesia induction.
- Primary endpoint: Time to extubation, analyzed using Cox regression.
Main Results:
- Adjusted analysis showed a significant increase in extubation hazard ratio with T3 (1.33; p=0.049), suggesting faster extubation.
- The effect was more pronounced in infants aged 5 months and younger (hazard ratio, 1.86; p=0.043).
- Median intubation time was significantly shorter in the T3 group for infants under 5 months (32.1 vs. 47.3 hours).
- Adverse event rates, including arrhythmias, were similar; sepsis was less frequent with T3.
Conclusions:
- Oral T3 supplementation appears to shorten extubation time in pediatric patients undergoing congenital heart disease surgery, especially in infants.
- The administration method is safe, simple, and cost-effective.
- T3 may be a valuable adjunct therapy in this patient population.
Background:
This study evaluated the efficacy and safety of oral triiodothyronine (T3; Tetronine, Dalim BioTech, Korea) for infants and children undergoing cardiopulmonary bypass in an Indonesian population.
Methods:
We performed a single-center, randomized, double-blind, and placebo-controlled trial in children aged 3 years and younger undergoing congenital heart disease operations with cardiopulmonary bypass. We administered oral T3 (1 μg/kg per body weight/dose) or placebo (saccharum lactis) by nasogastric tube every 6 hours for 60 hours after induction of anesthesia. The primary end point, time to extubation, was compared with Cox regression.
Results:
The modified intention-to-treat group included 101 placebo and 104 treated patients. The stratified log-rank test did not show a significant treatment difference (p = 0.061) for time to extubation, but after adjustment for age, the nutritional Z score, and Aristotle surgical complexity, the hazard ratio was 1.33 (95% confidence interval, 1.00 to 1.76; p = 0.049). The effect of T3 was stronger in the strata aged 5 months and younger (hazard ratio, 1.86; 95% confidence interval 1.02 to 3.39; p = 0.043). Median intubation time was 47.3 hours for the placebo and 32.1 hours for the T3 group in aged 5 months and younger. Adverse events rates, including arrhythmia, were similar between groups, although sepsis was more frequent with placebo.
Conclusions:
Oral T3 supplementation may shorten time to extubation in children undergoing congenital heart disease operations, particularly infants aged 5 months or younger. Administration is relatively safe, simple and inexpensive.
Related Concept Videos
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:29Drug Dosing: Infants and Children
01:28Imaging Studies for Cardiovascular System V: CT
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...