Interleukin-6 and thyroid hormone metabolism in pediatric cardiac surgery patients

Abstract

Pediatric patients undergoing cardiac surgery have been reported to have low serum triiodothyronine (T(3)) levels in the postoperative period. The cause of this dysfunction is not known, although proinflammatory cytokines such as interleukin-6 (IL-6) have been implicated in the inhibition of hepatic conversion of thyroxine (T(4)) to T(3). This study measured serum levels of IL-6 and T(3) during the first 4 postoperative days in 16 children (mean age, 28 +/- 7 days) undergoing cardiopulmonary bypass surgery. The mean preoperative serum total T(3) level was 164 +/- 30 ng/dL (2.5 +/- 0.5 nmol/L) that decreased significantly to a nadir of 43 +/- 8 ng/dL (0.6 +/- 0.01 nmol/L) within 48 hours after surgery. Serum IL-6 levels increased significantly from 16 +/- 7 pg/mL preoperatively to a peak value of 374 +/- 134 pg/mL measured 2-3 hours after surgery. A positive correlation (r(2) = 0.507) was found between the peak serum level of IL-6 and the lowest serum T(3) level in each patient attained during the 4 postoperative days. Potential treatments directed toward diminishing the rise in proinflammatory cytokines in the immediate postoperative period may prove effective in preventing the low serum T(3) in children undergoing cardiac surgery, and thus diminish the associated postoperative morbidity.