Thyroid Hormone Supplementation For Children Undergoing Cardiopulmonary Bypass For Congenital Heart Disease

Objective:Cardiopulmonary bypass (CPB) suppress circulating thyroid hormone(TH) levels. Although acute intravenous triiodothyronine has been evaluated in adults, children and infants after cardiac surgery with CPB, oral thyroid hormone supplementation have not previously studied in children undergoing operation for congenital heart disease. We hypothesized that oral TH before and after CPB may enhance postoperative cardiac function. Methods:Children less than 14 years old undergoing ventricular septal defect surgical procedure (some complicated foramen ovale and(or) patent ductus arteriousus) were randomized into 2 groups. Group T(n=10) received oral TH (oral tablet of 0. 4mg/(kg·d) for 2 days preoperatively and 3 days postoperatively. Control (NT, n=10) patients received placebo. TH and thyroid-syimulating hormone(TSH) were measured preoperatively and postoperatively in all patients. Jection fraction(EF),raction short (FS), systolic blood pressure(SBP), diastolic blood pressure(DBP), centre venous pressure(CVP), mean arterial pressure (MAP) were measured pre and postoperatively in group T and NT. The dosage of sodium nitroprusside(SNP) and dopamine(DA) were also measured postoperatively. Results: Before operation, the levels of TH in all patients were in normal range. Two groups underwent similar ischemic and bypass times and received similar quantities of intropic agents after the operation. For free triiodothyronine at the moment of after CPB and 24, 72 hours after...