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Triiodothyronine in cardiac surgery

T J Broderick1, A S Wechsler

  • 1Department of Surgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-1362, USA.

Thyroid : Official Journal of the American Thyroid Association
|February 1, 1997
PubMed
Summary

Triiodothyronine (T3) repletion is not recommended for routine use in cardiac surgery patients. However, T3 may benefit select patients unable to wean from cardiopulmonary bypass, acting as a rescue therapy.

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Area of Science:

  • Cardiology
  • Endocrinology
  • Cardiovascular Surgery

Background:

  • Thyroid hormones significantly impact cardiovascular function.
  • Hypothyroidism, both chronic and acute (euthyroid sick syndrome), is linked to cardiovascular dysfunction in various clinical settings like sepsis and cardiopulmonary bypass.
  • Cardiovascular complications are common in patients undergoing cardiac surgery.

Purpose of the Study:

  • To review laboratory experiments and clinical trials on triiodothyronine (T3) repletion in cardiac surgery.
  • To evaluate the efficacy and safety of T3 administration in this patient population.

Main Methods:

  • Review of animal experiments investigating T3 effects on postischemic cardiovascular dysfunction.
  • Analysis of clinical trials assessing T3 repletion in cardiac surgery.
  • Examination of anecdotal clinical experience regarding T3 use.

Main Results:

  • Animal studies indicate T3 repletion can improve postischemic cardiovascular dysfunction.
  • Rigorous clinical trials have not supported the routine use of T3 in cardiac surgery.
  • Anecdotal evidence suggests T3 may aid in weaning patients from cardiopulmonary bypass when other treatments fail.

Conclusions:

  • Routine administration of triiodothyronine (T3) is not recommended for patients undergoing cardiac surgery based on current clinical trial evidence.
  • T3 may be considered as a rescue agent at a specific dose (0.8 microgram/kg) for patients who cannot be weaned from cardiopulmonary bypass despite maximal inotropic support.
  • Further research may clarify the precise role of T3 in specific cardiac surgical scenarios.

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