Kevin R Plumpton1, Brian J Anderson, John Beca. 1. Starship Children's Hospital, Park Road, Grafton, Private Bag 92024, Auckland, New Zealand. kplumpton@ausdoctors.net
Abstract
PURPOSE: To investigate associations between thyroid hormone and cortisol concentrations after cardiac surgery and postoperative intensive care course. METHODS: Prospective observational study of 52 infants <3 months of age following congenital heart surgery. RESULTS: Infants with low tri-iodothyronine (< or =3.7 pmol/l) or high cortisol concentration on postoperative admission to the paediatric intensive care unit (PICU) were more likely to have a high inotrope requirement on postoperative day 2 (p = 0.003 and p = 0.0006, respectively) or need mechanical ventilation for longer than 96 h (p = 0.04 and p = 0.002, respectively). Total cortisol concentration < 200 nmol/l was found in 16 (31%) infants. There was no association between low cortisol and postoperative complications. CONCLUSIONS: Infants <3 months of age with low tri-iodothyronine or high cortisol concentration on PICU admission have a more complicated PICU course. Low cortisol concentration is common in the early postoperative period, but is not associated with postoperative complications.
PURPOSE: To investigate associations between thyroid hormone and cortisol concentrations after cardiac surgery and postoperative intensive care course. METHODS: Prospective observational study of 52 infants <3 months of age following congenital heart surgery. RESULTS:Infants with low tri-iodothyronine (< or =3.7 pmol/l) or high cortisol concentration on postoperative admission to the paediatric intensive care unit (PICU) were more likely to have a high inotrope requirement on postoperative day 2 (p = 0.003 and p = 0.0006, respectively) or need mechanical ventilation for longer than 96 h (p = 0.04 and p = 0.002, respectively). Total cortisol concentration < 200 nmol/l was found in 16 (31%) infants. There was no association between low cortisol and postoperative complications. CONCLUSIONS:Infants <3 months of age with low tri-iodothyronine or high cortisol concentration on PICU admission have a more complicated PICU course. Low cortisol concentration is common in the early postoperative period, but is not associated with postoperative complications.
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