Triiodothyronine therapy in open-heart surgery: from hope to disappointment.
Eur Heart J
; 14(5): 629-33, 1993 May.
Article
en En
| MEDLINE
| ID: mdl-8389710
ABSTRACT
A controversy persists as to whether cardiopulmonary bypass (CPB) decreases plasma levels of triiodothyronine (T3), thereby justifying peri-operative administration of T3 to improve haemodynamic recovery. To examine the effects of T3 therapy on post-CPB haemodynamics and to determine whether the potential inotropic effects of T3 are mediated by an increase in beta-adrenergic responsiveness, a prospective, randomized, double-blind, placebo-controlled study was performed in 20 patients undergoing cardiac surgery with CPB. T3 or placebo solution (10 patients in each group) was given intravenously at the time of aortic unclamping and 4, 8, 12 and 20 h thereafter. End points included (1) thyroid hormone levels measured by radioimmunoassay (2) standard haemodynamic parameters (3) the density of lymphocyte beta-adrenoceptors measured by a radioligand (125I-iodocyanopindolol) binding technique. Post-CPB values (cross clamp removal) of T3 (pg.ml-1) were not significantly decreased compared with pre-CPB values 3.3 +/- 0.2 vs 3.1 +/- 0.2 in controls and 3.3 +/- 0.4 vs 3.7 +/- 0.6 in T3-treated patients, respectively. The haemodynamic parameters were no different between the two groups at any postoperative time point. Likewise, density and affinity of lymphocyte beta-adrenoceptors were not significantly different from pre-operative values in either group. Thus, there seems to be no sound justification for a routine use of T3 in patients undergoing open-heart procedures.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Triyodotironina
/
Prótesis Valvulares Cardíacas
/
Puente Cardiopulmonar
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Puente de Arteria Coronaria
/
Enfermedad Coronaria
/
Aneurisma Cardíaco
/
Enfermedades de las Válvulas Cardíacas
/
Hemodinámica
Tipo de estudio:
Clinical_trials
/
Observational_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Eur Heart J
Año:
1993
Tipo del documento:
Article
País de afiliación:
Francia