Key result
T3 treatment stabilized hemodynamics and decreased inotropic support requirements in 45 of 61 adult and pediatric patients with severe low cardiac output.
Why the study?
Does T3 treatment improve hemodynamics in adult and pediatric patients with severe low cardiac output?
Observational (n=61)
Does T3 treatment improve hemodynamics in adult and pediatric patients with severe low cardiac output?
T3 treatment may improve hemodynamics and reduce inotropic requirements in a substantial proportion of cardiac surgery patients with severe low cardiac output.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for T3 in post-cardiac surgery low output; randomized trials needed before any practice change.
Thyroid hormone has multiple direct and indirect effects on the heart and the vasculature. Many signs and symptoms of thyroid dysfunction are manifest by the cardiovascular system. Furthermore, many cardiovascular diseases are adversely affected by the concomitant presence of either hyper- or hypothyroidism: it is still being debated whether these alterations are the consequence of increased cardiac workload alone or are due to the intrinsic properties of thyroid hormone. There are three potential mechanisms by which thyroid hormone might exert a cardiovascular action: (1) direct effects at the cellular level (inotropic and chronotropic effect); (2) interaction with the sympathetic nervous system; and (3) alteration of the peripheral circulation through changes in preload, afterload and energy metabolism. We treated 54 adult and seven pediatric patients suffering from severe low cardiac output in different clinical conditions with a mean bolus dosage of 2+/-1.5 microg h(-1) of T(3), followed by a continuous infusion of 0.4+/-0.3 microg h(-1) for a mean duration of 48+/-12 h. In 45 patients, stabilization of the hemodynamic situation with a decrease in inotropic support requirement was observed; however, in 11 patients no beneficial effects were observed. From this experience we suggest that T(3) treatment may improve hemodynamics in a substantial proportion of cardiac and cardiosurgical patients in whom more conventional treatment is unsuccessful.
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Carrel et al. (2002) conducted an observational in Severe low cardiac output (n=61). T3 (Thyronin) was evaluated on Stabilization of the hemodynamic situation with a decrease in inotropic support requirement. T3 treatment stabilized hemodynamics and decreased inotropic support requirements in 45 of 61 adult and pediatric patients with severe low cardiac output.
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