Dissertation > Medicine, health > Pediatrics > Pediatric surgery > Surgery in children of all physiological systems

Experimental study of children with congenital heart disease around cardiopulmonary bypass thyroid hormone changes and thyroid hormone replacement therapy (T_3)

Author WangXu
Tutor LiuYingLong;XiaoMingDi
School Peking Union Medical College , China
Course Science in Cardiovascular Surgery
Keywords Serum thyroid hormone Cardiopulmonary bypass Graduate thesis Children with congenital heart disease Medical Ventricular septal defect Replacement therapy Ischemia-reperfusion injury Early postoperative Thyroid function
CLC R726.5
Type PhD thesis
Year 1998
Downloads 72
Quotes 0
Download Dissertation

I. The Change of Thyroid Hormones in Children During and After CPB and Clinical Implications1.Thyroid Hormones Change in Children of Ventricular Septal Defects (VSD) with Pulmonary Hypertension During and After CPBThe concentrations of thyroid hormones during and after operation were measured 11 children of VSD with pulmonary hypertention. The results demonstrated that the TT3、 TT4 level decreased significantly during CPB and were 56.2%(P<0.01) and 68.0%(P<0.01) of the baseline values respectively. At 2h after operation, the TT3、 TT4 level showed a tendency toward returning to preoperative levels 992.9%), but at 4h postoperatively, the TT3 level declined again and reached its lowest level at 36h postoperation(55.9%, P<0.01). The TT4 had little changes at early postoperative period, but decreased to 66.5%(P<0.01) of the baseline values at 48-72h. fT3 declined significantly to 45% of its baseline values during CPB. Two hours later, it increased slightly to 68% (PO.01), and decreased to the lowest point (47.1%, P<0.01) at 16-36h after operation, and then remained lower levels to 72h (62.6%, P<0.01). fT4 level had little changes during CPB and 2h after operation. The serum level only less than normal level at the time from 24-36h, and returned to the normal level at 48h. TSH level increased slightly during CPB and 2h after operation. They were 108% and 112.7% of their baseline values respectively and declined at 4h after operation. At 24h, they were 50% of the baseline values. 36h later, they increased significantly nearly of exceed to the pre-operative levels. rT3 decreased during CPB and increased to the highest point at 36h after operation(205.6%,P<0.01).At 48h, it showed a slight declined tendency.Our study showed that during CPB and 2h after operation, because of hemodilution all thyroid hormones including TT3、 TT4、 fT3、 rT3 but TSH、 fT4 decreased significantly, and declined again at 4h after operation and reached their lowest levels at 16-36h. TSH was the first hormone to return to the baseline at 36h,

Related Dissertations
More Dissertations