Definition: triiodothyronine levels decrease in infants and children after cardiopulmonary bypass. Lower T3 concentration is associated with a more complicated recovery in PICU after congenital heart surgery. T3 is safe and has proven clinical benefit in infants less than 5 months of age. Given prophylactically before and after cardiopulmonary bypass, T3 decreases ventilation time and inotrope requirement and improves cardiac function compared to placebo.
Infants less than 5 months of age having congenital heart surgery with cardiopulmonary bypass.
T3 treatment regimen:
- 0.4 mcg/kg immediately prior to going on to CPB
- 0.4 mcg/kg on release of aortic cross clamp
- 0.2 mcg/kg at 3 hrs after cross clamp removal
- 0.2 mcg/kg at 6 hrs after cross clamp removal
- 0.2 mcg/kg at 9 hrs after cross clamp removal
A single vial can be used for multiple doses for a single patient up to 24 hrs after opening, but must be kept in the fridge once open.
 Bartkowski, R., et al., Thyroid hormones levels in infants during and after cardiopulmonary bypass with ultrafiltration. Eur J Cardiothorac Surg, 2002. 22(6): p. 879-84.
 Plumpton, K. et al, Identifying infants at risk of marked thyroid suppression post-cardiopulmonary bypass. Intensive Care Med, 2005. 31(4): p. 581-7.
 Plumpton, K.R., B.J. Anderson, and J. Beca, Thyroid hormone and cortisol concentrations after congenital heart surgery in infants younger than 3 months of age. Intensive Care Med, 2009. 36(2): p. 321-8.
 Portman, M.A., et al., Triiodothyronine Supplementation in Infants and Children Undergoing Cardiopulmonary Bypass (TRICC): a multicenter placebo-controlled randomized trial: age analysis. Circulation, 2010. 122(11 Suppl): p. S224-33.
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