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Effects of Intravenous Triiodothyronine During Coronary Artery Bypass Surgery

Mustafa Güden, MD, Belhhan Akpinar, MD, Ertan Sagba, MD, lhan Sanisolu, MD, Emine Cakali, MD¹, Osman Bayindir, MD¹

Department of Cardiovascular Surgery 1 Department of Anesthesia Kadir Has University, Florence Nightingale Hospital Istanbul, Turkey
For reprint information contact: Belhhan Akpinar, MD Tel: 90 212 224 4950 Fax: 90 212 239 8791 email: belh{at}turk.net Department of Cardiovascular Surgery, Kadir Has University, Florence Nightingale Hospital, Abide-i Hürriyet Caddesi No. 290 Süisüli, 'ag layan, Istanbul 80220, Turkey.

A prospective randomized and double-blind study was performed to evaluate whether perioperative triiodothyronine administration has any effect on cardiovascular performance after coronary artery bypass surgery. Sixty patients were assigned to 2 groups of 30 each. When crossclamping ended, group A received an intravenous bolus of triiodothyronine, followed by infusion for 6 hours. Group B received a placebo. Serum triiodothyronine levels and hemo-dynamic parameters were serially measured. Mean postoperative cardiac index was slightly, but not significantly, higher in group A, whereas systemic vascular resistance was significantly lower in group A. Compared with preoperative values, serum triiodothyronine levels dropped significantly in group B at the end of cardiopulmonary bypass and remained low 12 hours postoperatively, while levels rose significantly in group A. No significant differences were detected between the groups in the incidence of arrhythmia, the need for inotropic support, intensive care unit stay, mortality, and morbidity. Perioperative administration of triiodothyronine increased cardiac output slightly and decreased systemic vascular resistance, but it had no effect on operative outcome. Routine use after coronary surgery is thus not recommended.

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