Relationship between changes in thyroid hormone level and severity of the postoperative course in neonates undergoing open-heart surgery.
BACKGROUND
Our aim was to determine whether the changes in thyroid function after open-heart surgery in neonates depend on the postoperative course.


METHODS
Twenty neonates undergoing open-heart surgery for congenital heart disease were prospectively studied in the cardiac intensive care unit of a university-affiliated children's hospital. The patients were divided into two groups by level of inotropic support (high or mild).


RESULTS
The groups were similar in age, bypass time and ultrafiltration volume. In both groups, there was a significant reduction in levels of thyroid-stimulating hormone and FT4 at 24 h postoperatively. However, in the high inotropic support group, FT4 was lower for a longer time. This group also had a significantly higher score on The Pediatric Risk of Mortality (PRISM; P < 0.042) and a longer duration of ventilation (P < 0.014).


CONCLUSIONS
Neonates after open-heart surgery undergo changes in thyroid function characteristic of euthyroid sick syndrome. The degree of hypothyroxinemia may be related to the severity of illness and the postoperative course.
Dagan
Ovadia
O
Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petah Tiqwa, Israel. cicu_schneider@clalit.org.il
Vidne
Bernardo
B
Josefsberg
Zeev
Z
Phillip
Moshe
M
Strich
David
D
Erez
Eldad
E