title: Efficacy of perioperative oral triiodothyronine replacement therapy in patients undergoing off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  The aim of this study was to assess the effects of oral triiodothyronine (T3) therapy on postoperative thyroid hormone concentrations, hemodynamic variables, and outcomes.
  
  
  METHODS
  A prospective, randomized, controlled, double-blind study.
  
  
  METHODS
  Cardiac operating room at a single institution.
  
  
  METHODS
  One hundred patients undergoing elective off-pump coronary artery bypass graft surgery.
  
  
  METHODS
  Patients received either 20 μg of oral T3 or placebo every 12 hours starting 20 minutes before anesthetic induction, for a total of 4 doses.
  
  
  RESULTS
  Plasma concentrations of thyroid hormones were measured serially before surgery, upon arrival in the intensive care unit, and 12, 24, and 36 hours after surgery. Hemodynamic variables also were recorded serially. Postoperative inotrope requirement and major morbidity endpoints were assessed. Serum T3 concentrations were significantly higher with fewer patients having T3 concentrations below the normal range in the T3 group than the placebo group throughout the postoperative period. Hemodynamic variables, postoperative inotrope requirement, and outcome variables showed no differences between the groups.
  
  
  CONCLUSIONS
  Oral T3 therapy significantly attenuated the postoperative decline in T3 concentrations in patients undergoing off-pump coronary artery bypass graft surgery. The lack of apparent clinical benefit merits further investigations in patients with reduced cardiac performance.
authors: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine.
authors: Yong Seon
authors: YS
authors: Choi
authors: Jae Kwang
authors: JK
authors: Shim
authors: Jong Wook
authors: JW
authors: Song
authors: Young
authors: Y
authors: Song
authors: So-Young
authors: SY
authors: Yang
authors: Young Lan
authors: YL
authors: Kwak
mesh_terms: D000328:Adult; D000368:Aged; D002316:Cardiotonic Agents / Q000627:therapeutic use; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003422:Critical Care; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D020249:Hormone Replacement Therapy / Q000379:methods*; D017052:Hospital Mortality; D006801:Humans; D008136:Longevity; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D013963:Thyroid Hormones / Q000097:blood; D016896:Treatment Outcome; D014284:Triiodothyronine / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D002316:Cardiotonic Agents; D013963:Thyroid Hormones; D014284:Triiodothyronine
keywords: nonthyroidal illness syndrome; off-pump coronary artery bypass graft surgery; triiodothyroinine