The Effect of Oral Triiodothyronine in Outcome of Pediatric Congenital Cardiac Surgery

Background: Cardiac surgery especially in small children is associated with a marked decrease in thyroid hormone levels consistent with the phenomenon referred to as Sick Euthyroid Syndrome (SES). The purpose of the present study was to determine if oral triiodothyronine could reduce the length of ICU stay, vasoactive inotropic score (VIS), and promote ejection fraction in infants and children undergoing cardiac surgery with CPB. Materials and Methods: In a double-blind clinical trial, one hundred and twenty children aged 6 to 60 months and scheduled for different types of cardiac surgery with CPB, were randomized into two groups to receive either 2 mcg/Kg triiodothyronine (trial group) or 5% dextrose water (placebo group), immediately after anesthesia and 24 hours after surgery. The perioperative serum thyroid hormone levels and hemodynamic variables were determined. The intubation time, ICU stay length, ICU inotropic use, and cardiac ejection fraction was recorded. Results: The basic demographic data were comparable in two groups. No significant side effects or adverse reactions were seen due to hormone therapy. Intubation time, ICU stay, and VIS values were significantly shorter between the two groups. Conclusion: In children undergoing cardiac surgery with CPB, perioperative oral small-dose triiodothyronine therapy could improve clinical indices of perioperative care.