Hypothalamic-Pituitary-Thyroid Axis Changes in Children after Cardiac Surgery

• DOI: 10.1210/jc.2008-2722
• Publication Date: 2009-06-03T00:58:41Z
• Authors: Seth D. Marks; Christina Haines; Ivan M. Rebeyka; Robert M. Couch
• Keywords: Hypothalamic–pituitary–thyroid axis

Hypothalamic-pituitary-thyroid axis changes in critical illness result nonthyroidal syndrome (NTIS) characterized by abnormal TSH and thyroid hormone levels. It is unclear whether NTIS adaptive or maladaptive. Some have suggested that adversely affects outcome, but there are limited data children.Our objective was to determine the natural history of children undergoing cardiac bypass surgery correlate these with outcome severity.Thyroid function measured 21 patients, aged 1-11 yr, preoperatively postoperatively twice daily on postoperative days (POD) 0-3 thereafter until POD 7. Pediatric Logistic Organ Dysfunction inotrope scores pediatric intensive care unit, hospital, ventilation were statistically analyzed relation function.All patients exhibited within first day postoperatively. recovered 4. Total T(3), free T(3) index, uptake still below preoperative levels correlated prolonged hospital stays increased unit mechanical also showed strong relations scores. The measures drawn 6-14 h from predictive clinical outcome. Alterations severity preceded function.NTIS present this population critically ill some biochemical not corrected 8 d degree related severity.