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Cardiopulmonary bypass and thyroid hormone metabolism
1Cardiovascular and Pulmonary Research Center, Allegheny-Singer Research Institute, Pittsburgh, PA 15212.
The Annals of Thoracic Surgery
|July 1, 1993
Summary
Cardiopulmonary bypass (CPB) reduces active thyroid hormone (T3) levels, potentially causing the euthyroid sick syndrome. Intravenous T3 administration during CPB has shown promise in improving cardiac function.
Area of Science:
- Cardiology
- Endocrinology
- Thyroid Hormone Physiology
Background:
- Thyroid hormone levels are critical for cardiac function.
- Cardiopulmonary bypass (CPB) is a complex procedure used during cardiac surgery.
- Patient response to thyrotropin-releasing hormone during cardiac operations has been previously investigated.
Purpose of the Study:
- To investigate the impact of cardiopulmonary bypass (CPB) on thyroid hormone levels.
- To explore the potential of intravenous T3 administration in patients undergoing CPB.
- To review existing studies on thyroid hormone status before, during, and after CPB.
Main Methods:
- Review of clinical trials and studies.
- Analysis of thyroid hormone concentrations (total T3) during and after CPB.
- Investigation of the monodeiodinase pathway's role in thyroid hormone conversion.
Main Results:
- Significant reduction in total T3 concentrations during and after CPB, indicative of euthyroid sick syndrome.
- Potential inhibition of peripheral thyroxine to T3 conversion during CPB.
- Intravenous T3 administration during or after CPB improved cardiac output and contractility in clinical trials.
Conclusions:
- CPB significantly affects thyroid hormone levels, leading to reduced active T3.
- Intravenous T3 administration is a potential therapeutic strategy to mitigate CPB-induced thyroid dysfunction and improve cardiac performance.
- Further research is warranted to fully understand thyroid hormone dynamics during CPB.