Thyroid function during coronary surgery with and without cardiopulmonary bypass
Thyroid function during coronary surgery with and without cardiopulmonary bypass
Objective: cardiopulmonary bypass (CPB) is associated with thyroid hormone changes consistent with euthyroid sick syndrome. Similar changes have been observed after general surgical operations. Thyroid hormone changes and their association with global oxygen consumption were studied in low-risk patients undergoing coronary artery bypass grafting (CABG) with and without CPB.
Methods: fifty-two patients undergoing primary CABG by the same surgeon were randomised into either on-pump (ONCAB, n = 26) or off-pump (OPCAB, n = 26) groups. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) levels were measured at sequential time-points using chemiluminescence assays. Global oxygen consumption was measured at sequential time-points using a continuous cardiac output Swan-Ganz catheter.
Results: in both groups TSH and fT4 remained within normal range throughout the study. There was a similar and progressive decline in fT3 levels with no significant difference between the groups over time (p = 0.42). Mean fT3 levels at 24 h were below the normal range and significantly lower than baseline values (ONCAB, 3.3 ± 0.69 pmol/L vs 5.1 ± 0.41 pmol/L, p < 0.001; OPCAB, 3.3 ± 0.51 pmol/L vs 5.0 ± 0.46 pmol/L, p < 0.001). There was a significant inverse relationship between fT3 levels and global oxygen consumption.
Conclusions: off-pump surgery is associated with thyroid hormone changes similar to conventional surgical revascularisation. The data suggest that further studies into T3 administration during OPCAB may be warranted
coronary surgery, cardiopulmonary bypass, off-pump, thyroid
148-154
Velissaris, Theodore
731d89bf-8c7a-4e68-ab6c-61e815d94415
Tang, Augustine T.M.
2f44db5d-b12a-4911-b269-3f68b4d82a82
Wood, Peter J.
30039979-9541-4a0a-8aef-0dfe53114e02
Hett, David A.
b05d7d54-3a3d-44df-9bee-8494934f3364
Ohri, Sunil K.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
July 2009
Velissaris, Theodore
731d89bf-8c7a-4e68-ab6c-61e815d94415
Tang, Augustine T.M.
2f44db5d-b12a-4911-b269-3f68b4d82a82
Wood, Peter J.
30039979-9541-4a0a-8aef-0dfe53114e02
Hett, David A.
b05d7d54-3a3d-44df-9bee-8494934f3364
Ohri, Sunil K.
8aa5698c-78cf-4f59-a5af-5afa46f0348c
Velissaris, Theodore, Tang, Augustine T.M., Wood, Peter J., Hett, David A. and Ohri, Sunil K.
(2009)
Thyroid function during coronary surgery with and without cardiopulmonary bypass.
European Journal of Cardio-thoracic Surgery, 36 (1), .
(doi:10.1016/j.ejcts.2008.12.054).
Abstract
Objective: cardiopulmonary bypass (CPB) is associated with thyroid hormone changes consistent with euthyroid sick syndrome. Similar changes have been observed after general surgical operations. Thyroid hormone changes and their association with global oxygen consumption were studied in low-risk patients undergoing coronary artery bypass grafting (CABG) with and without CPB.
Methods: fifty-two patients undergoing primary CABG by the same surgeon were randomised into either on-pump (ONCAB, n = 26) or off-pump (OPCAB, n = 26) groups. Thyroid-stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3) levels were measured at sequential time-points using chemiluminescence assays. Global oxygen consumption was measured at sequential time-points using a continuous cardiac output Swan-Ganz catheter.
Results: in both groups TSH and fT4 remained within normal range throughout the study. There was a similar and progressive decline in fT3 levels with no significant difference between the groups over time (p = 0.42). Mean fT3 levels at 24 h were below the normal range and significantly lower than baseline values (ONCAB, 3.3 ± 0.69 pmol/L vs 5.1 ± 0.41 pmol/L, p < 0.001; OPCAB, 3.3 ± 0.51 pmol/L vs 5.0 ± 0.46 pmol/L, p < 0.001). There was a significant inverse relationship between fT3 levels and global oxygen consumption.
Conclusions: off-pump surgery is associated with thyroid hormone changes similar to conventional surgical revascularisation. The data suggest that further studies into T3 administration during OPCAB may be warranted
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Published date: July 2009
Keywords:
coronary surgery, cardiopulmonary bypass, off-pump, thyroid
Identifiers
Local EPrints ID: 69900
URI: http://eprints.soton.ac.uk/id/eprint/69900
ISSN: 1010-7940
PURE UUID: 54b5d83c-5b50-4875-a82d-dbd6277fff7d
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Date deposited: 11 Dec 2009
Last modified: 16 Jul 2024 17:13
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Contributors
Author:
Theodore Velissaris
Author:
Augustine T.M. Tang
Author:
Peter J. Wood
Author:
David A. Hett
Author:
Sunil K. Ohri
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