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Thyroid function during and after cardiopulmonary bypass in children

K Saatvedt1, H Lindberg, O R Geiran

  • 1Surgical Department A, Rikshospitalet, Oslo, Norway.

Insights

Pediatric thyroid function, including triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH), significantly decreases after cardiopulmonary bypass (CPB) during heart surgery.

Area of Science:

  • Pediatric Endocrinology
  • Cardiovascular Surgery
  • Thyroid Physiology

Background:

  • Cardiopulmonary bypass (CPB) is a critical procedure in pediatric cardiac surgery.
  • Thyroid hormone levels can be affected by major surgical stress and physiological changes.

Purpose of the Study:

  • To investigate alterations in thyroid function during and after CPB in children.
  • To quantify changes in key thyroid hormones and TSH levels.

Main Methods:

  • Prospective study involving 10 children undergoing elective congenital heart defect surgery.
  • Measurement of triiodothyronine (T3), thyroxine (T4), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) at multiple time points: preoperatively, during CPB, and up to 48 hours postoperatively.

Main Results:

  • Significant decrease in T3 and T4 levels observed 24 hours postoperatively.
  • Transient increase in free thyroxine (FT4) noted early during CPB.
  • Significant reduction in TSH levels 24 hours after surgery.

Conclusions:

  • Pediatric patients undergoing open-heart surgery with CPB experience significant depression of T3, T4, and TSH levels.
  • Thyroid function monitoring is crucial in the perioperative period for children undergoing CPB.
Abstract

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