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. 2022 Mar 9;22(1):66.
doi: 10.1186/s12871-022-01608-6.

Decreased triiodothyronine (T3) as a predictor for prolonged mechanical ventilation in critically ill patients with cardiac surgery

Xiao Shen #  1 , Jiakui Sun #  1 , Liang Hong  1 , Xiaochun Song  1 , Cui Zhang  2 , Ying Liu  1 , Han Liu  1 , Guojian Li  3 , Xinwei Mu  4
Affiliations

Decreased triiodothyronine (T3) as a predictor for prolonged mechanical ventilation in critically ill patients with cardiac surgery

Xiao Shen et al. BMC Anesthesiol. .

Abstract

Background: This study aimed to examine the correlation between thyroid hormone and prolonged mechanical ventilation (MV) in adult critically ill patients having undergone cardiac surgery.

Methods: The present study refers to a retrospective, cohort study conducted at Nanjing First Hospital from March 2019 to December 2020. Patients receiving cardiac surgery and admitting to the Cardiovascular Intensive Care Unit (CVICU) in the study period were screened for potential inclusion. Demographic information, thyroid hormone and other laboratory measurements and outcome variables were recorded for analysis. Prolonged MV was defined as the duration of MV after cardiac surgery longer than 5 days. Thyroid hormones were assessed for the prognostic significance for prolonged MV.

Results: One thousand eight hundred ninety-six patients who underwent cardiac surgery were screened for potential enrollment. Overall, 118 patients were included and analyzed in this study. Patients fell to the control (n = 64) and the prolonged MV group (n = 54) by complying with the duration of MV after cardiac surgery. The median value of total triiodothyronine (TT3) and free triiodothyronine (FT3) were 1.03 nmol/L and 3.52 pmol/L in the prolonged MV group before cardiac surgery, significantly lower than 1.23 nmol/L (P = 0.005) and 3.87 pmol/L, respectively in control (P = 0.038). Multivariate logistic regression analysis indicated that TT3 before surgery (pre-op TT3) had an excellent prognostic significance for prolonged MV (OR: 0.049, P = 0.012).

Conclusions: This study concluded that decreased triiodothyronine (T3) could be common in cardiac patients with prolonged MV, and it would be further reduced after patients undergo cardiac surgery. Besides, decreased T3 before surgery could act as an effective predictor for prolonged MV after cardiac surgery.

Keywords: Cardiac surgery; Non-thyroidal illness syndrome; Prolonged mechanical ventilation; Triiodothyronine.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Screening of the study patients
Fig. 2
Fig. 2
Box-and-whisker plots for thyroid hormone before and after cardiac surgery in patients of control group and prolonged MV group. A. Serum level of TT3 before and after cardiac surgery in the patients of the two groups. B. Serum level of FT3 before and after cardiac surgery in the patients of the two groups. C. Serum level of TT4 before and after cardiac surgery in the patients of the two groups. D. Serum level of FT4 before and after cardiac surgery in the patients of the two groups. *: P < 0.05 vs. Control group, **: P < 0.01 vs. Control group; #: P < 0.05 vs. pre-op, ##: P < 0.01 vs. pre-op, ###: P < 0.001 vs. pre-op
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References

    1. Ranasinghe AM, Bonser RS. Thyroid hormone in cardiac surgery. Vasc Pharmacol. 2010;52(3–4):131–137. doi: 10.1016/j.vph.2009.11.004. - DOI - PubMed
    1. Warner MH, Beckett GJ. Mechanisms behind the non-thyroidal illness syndrome: an update. J Endocrinol. 2010;205(1):1–13. doi: 10.1677/JOE-09-0412. - DOI - PubMed
    1. Kumar E, McCurdy MT, Koch CA, Hamadah A, Fulop T, Gharaibeh KA. Impairment of thyroid function in critically ill patients in the intensive care units. Am J Med Sci. 2018;355(3):281–285. doi: 10.1016/j.amjms.2017.06.026. - DOI - PubMed
    1. Bello G, Pennisi MA, Montini L, Silva S, Maviglia R, Cavallaro F, Bianchi A, De Marinis L, Antonelli M. Nonthyroidal illness syndrome and prolonged mechanical ventilation in patients admitted to the ICU. Chest. 2009;135(6):1448–1454. doi: 10.1378/chest.08-1816. - DOI - PubMed
    1. Padhi R, Kabi S, Panda BN, Jagati S. Prognostic significance of nonthyroidal illness syndrome in critically ill adult patients with sepsis. Int J Crit Illn Inj Sci. 2018;8(3):165–172. - PMC - PubMed

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