Cardiovascular effects of intravenous triiodothyronine in patients undergoing coronary artery bypass graft surgery. A randomized, double-blind, placebo- controlled trial. Duke T3 study group
Abstract
To test the hypothesis that triiodothyronine (T(3)) administration improves hemodynamic variables and decreases inotropic drug requirements in cardiac surgery patients. Prospective, randomized, double-blind, placebo-controlled trial. Tertiary care medical center. A total of 211 patients undergoing coronary artery surgery at high risk for requiring inotropic drug support. At release of aortic cross-clamp, patients were randomized to an intravenous infusion of T(3) (0.8 microg/kg followed by 0.12 microg.kg(-1).h(-1) for 6 hours), dopamine (positive control, 5 microg.kg(-1).min(-1) for 6 hours) or placebo. Perioperative hemodynamic variables, inotropic support requirements, and serum T(3) concentrations. Mean+/-SEM free T(3) serum concentrations decreased significantly during cardiopulmonary bypass in all groups (from 0.0035+/-0.0001 nmol/L [0.23+/-0.01 ng/dL] to 0.001+/-0.0001 nmol/L [0.7+/- 0.00 ng/dL]; P=.001) and increased to 0.0133+/-0.0004 nmol/L [0.87+/-0.03 ng/dL] (twice normal range; P<.001) following initiation of intravenous T(3). Intravenous T(3) did not change hemodynamic variables or inotropic drug requirements; however, heart rate increased (P<.001), and a trend toward decreased use of inotropic agents was demonstra...Continue Reading
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