Thyroid hormone alterations during and after cardiopulmonary bypass

Keçeligil, Hasan Tahsin; Kolbakir, F.; Adam, Bahattin; Arıkan, Ali Ahmet; Erk, M.K.

doi:10.1016/0967-2109(95)00118-2

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…Changes in TT3, TT4 and fT3 levels were compatible with the ESS. 13 Comparable results have been found also in infants. Plumpton et al studied 36 infants undergoing CPB for congenital heart surgery.…”

Section: The Consequences Of Cpb On Thyroid Functionmentioning

confidence: 61%

Euthyroid sick syndrome in paediatric and adult patients requiring extracorporeal circulatory support and the role of thyroid hormone supplementation: a review

Nistal-Nuño

2020

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Non-thyroid disorders may modify thyroid hormone metabolism, resulting in an ‘euthyroid sick syndrome’. Studies determining the association of cardiopulmonary bypass to thyroid function showed changes in line with this euthyroid sick syndrome. In some cases, cardiovascular dysfunction after cardiac surgery with cardiopulmonary bypass is comparable to that noticed in hypothyroidism associated with low cardiac output and elevated systemic vascular resistance. Numerous lines of research have proposed that triiodothyronine can behave acutely as a positive inotropic and vasodilator agent. The aim of this review is to present an update on the current literature about in what clinical situations the use of thyroid supplementation during the perioperative period of extracorporeal circulation in the adult and paediatric populations may impact outcome to any appreciable degree. The contribution of thyroid function in patients undergoing a ventricular assist device implantation is additionally reviewed and future study directions are proposed. This is a narrative review, where the search strategy consisted on retrieving the articles through an extensive literature search performed using electronic databases from January 1978 up to September 2019. All controlled trials randomly allocating to perioperative thyroid hormone administration in children and adults undergoing extracorporeal circulation for cardiac surgery were considered. Thyroid hormone supplementation may be recommended particularly in selected paediatric sub-populations. There is currently no firm evidence regarding the benefits of routine use of thyroid hormone administration in cardiac adult patients. Further studies are required to assess the beneficial effect of thyroid hormone on patients with end-stage heart failure supported by ventricular assist devices.

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Section: The Consequences Of Cpb On Thyroid Functionmentioning

confidence: 61%

Euthyroid sick syndrome in paediatric and adult patients requiring extracorporeal circulatory support and the role of thyroid hormone supplementation: a review

Nistal-Nuño

2020

Perfusion

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“…Zaloga et al reported two previously euthyroid patients; one developed hyperthyroidism 3 weeks after cardiac surgery, and the other developed hyperthyroidism progressively over 6 months following a hysterectomy [8]. Keceligil et al evaluated thyroid function in 20 patients before, during, and after cardiopulmonary bypass and found that cardiopulmonary bypass could affect thyroid hormone metabolism, leading to a transient depression characterized by low levels of circulating T 4 and T 3 [9].…”

Section: Discussionmentioning

confidence: 99%

Acute Psychotic State due to Hyperthyroidism Following Excision of a Mandible Bone Tumor: A Case Report

Yang

Wang

Chen

2003

The Kaohsiung J of Med Scie

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The etiology of psychotic symptoms that emerge following surgery needs to be sought to allow physicians to provide effective treatment. We present the case of a patient who developed hyperthyroidism shortly after excision of a mandible bone tumor and discuss its clinical features, course, and management. A 48-year-old female without previous thyroid disease accidentally found a tumor over her left mandible bone and underwent excision of the tumor. Soon after surgery, she suffered from anxiety, mood swings, insomnia, and even auditory hallucinations. Through careful differential diagnosis and a series of examinations, she was shown to be in a hyperthyroid state. Her condition improved after short-term use of haloperidol, lithium, and methimazole. Her thyroid function recovered and she was free from any psychiatric symptoms during the 1-year follow-up. Hyperthyroidism following surgery is not uncommon and its possibility should be considered when making differential diagnoses.

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“…Many abnormalities along the pituitary-thyroid axis have been observed in critical illness associated with sepsis, myocardial infarction, cardiopulmonary bypass, and surgery [11][12][13][14][15]. Such abnormalities include an attenuated response of thyroid stimulating hormone (TSH) to thyrotropin releasing hormone (TRH), decreased pulsatile TSH release, and decreased serum thyroid hormone levels.…”

Section: Altered Thyroid Physiology In Critical Illnessmentioning

confidence: 99%