Thyroid Supplement Improves Outcome for Infants Undergoing Cardiopulmonary Bypass

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Infants undergoing cardiopulmonary bypass may spend less time on a respirator if they receive thyroid supplementation, according to a new study published in the journal Circulation. Scientists at The Feinstein Institute for Medical Research have pioneered research in the relationship between a thyroid hormone and cardiovascular disease. The Feinstein Institute’s Sara Danzi, PhD, collaborated with doctors throughout the country to test the idea that T3 supplementation in infants and children during surgery might be protective and lead to less time on intubation.

Infants undergoing cardiopulmonary bypass may spend less time on a respirator if they receive thyroid supplementation, according to a new study published in the journal Circulation. Scientists at The Feinstein Institute for Medical Research have pioneered research in the relationship between a thyroid hormone and cardiovascular disease. The Feinstein Institute’s Sara Danzi, PhD, collaborated with doctors throughout the country to test the idea that T3 supplementation in infants and children during surgery might be protective and lead to less time on intubation.

It has been known from the Feinstein research that T3 levels drop during chronic illness and acute trauma. T3 has profound effects on virtually every tissue and organ system, including control of the cardiovascular system. Thus, T3 depletions become particularly important in heart failure. Scientists have tested the preventive intervention in adults undergoing cardiac bypass and it seemed to improve the cardiac index.

Infants are much more vulnerable to problems during bypass so scientists designed a multicenter, placebo-controlled, randomized trial to see whether infants and young children spent fewer days on a respirator if they had been given an intravenous dose of thyroid hormone. Michael A. Portman, MD, Director, Pediatric Cardiovascular Research at Seattle Children’s Hospital, was the lead author of the study. The study involved 193 infants under age two. The children were matched by anomaly and age and then randomized into a treatment or control group. After the surgery, the researchers looked to see how long it was before their breathing tubes were removed.

There was a significant benefit for the most vulnerable children: those under five months old. The mean time to extubation was 98 hours in the placebo group, compared to 55 hours in those treated with T3 before surgery. The time to extubation is a measure that suggests children are doing better and could breathe without a machine assisting them.

T3 supplementation did not make a difference for the older children, who are healthier and do better on the heels of surgery, according to Dr. Danzi. “Maybe someday this will be a standard of care for infants undergoing bypass surgery,” she said.

About The Feinstein Institute for Medical Research

Headquartered in Manhasset, NY, The Feinstein Institute for Medical Research (http://www.feinsteininstitute.org) is home to international scientific leaders in cancer, leukemia, lymphoma, Parkinson's disease, Alzheimer’s disease, psychiatric disorders, rheumatoid arthritis, lupus, sepsis, inflammatory bowel disease, diabetes, human genetics, neuroimmunology, and medicinal chemistry. Feinstein researchers are developing new drugs and drug targets, and producing results where science meets the patient, annually enrolling some 10,000 subjects into clinical research programs.

Contact: Jamie Talan
Science writer-in-residence
Phone: 516-562-1232
Email: jtalan(at)nshs(dot)edu

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Jamie Talan
North Shore Long Island Jewish Health System
516-562-1232
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