![]() These data provide further support for investigational trials of intravenous administration of T 3 in the prevention or treatment of low cardiac output syndrome after cardiopulmonary bypass. The hemodynamic effects of primary hypothyroidism are well established. These results indicate that cardiopulmonary bypass simulates the “euthyroid sick syndrome” as seen in severely burned patients and critically ill patients, which is characterized by depression of T 3 and free T 3 concentrations with a concomitant increase in reverse T 3 levels and normal concentrations of thyroid-stimulating hormone, thyroxine, and free thyroxine. While 7 to 60 of euthyroid sick dogs will have a low T4 concentration, depending on the severity of the disease (the more severe the more likely to develop a low T4 concentration). ![]() Thyroid-stimulating hormone, thyroxine, and free thyroxine levels remained within normal ranges at all sampling times. The combined T4 and TSH determination is the recommended approach to diagnosis of hypothyroidism since this combination will minimize false positive results. Up to now, it has not been recognized that children with cancer might. Thyroid-binding globulin was decreased at all sampling times ( p < 0.05). Euthyroid sick syndrome has been associated with a worse prognosis in cancer patients. Reverse T 3 demonstrated a greater than fourfold rise at 8 and 24 hours postoperatively ( p < 0.05). Values of total T 3 and free T 3, the active hormone, were significantly depressed (75% and 50%, respectively) up to 24 hours after bypass ( p < 0.05). Free T 3 was assayed by equilibrium dialysis. ![]() Thyroid-stimulating hormone, thyroid-binding globulin, total thyroxine, triiodothyronine (T 3), and reverse T 3, an inactive metabolite of thyroxine, were measured by radioimmunoassay. Blood samples were obtained from 14 patients preoperatively, at specific times throughout cardiopulmonary bypass, and serially to 24 hours postoperatively. The purpose of this prospective study was to define the effect of cardiopulmonary bypass on the concentrations of thyroid hormones and metabolites.
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