Low free triiodothyronine levels in mexican pediatric population with congenital heart disease after cardiac surgery undergoing cardiopulmonary bypass.

Azucena Martinez ,Esther Beltran ,Héctor Díliz Nava ,Luis García-Benítez ,Francisco Juárez ,Orlando Tamaríz-Cruz ,Alexis Palacios Macedo-Quenot

doi:10.18233/apm37no5pp254-259

Azucena Martinez , Esther Beltran + Show 5 more

Open Access

https://doi.org/10.18233/apm37no5pp254-259

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Abstract

BACKGROUND: Low free triiodothyronine level in patients undergoing heart surgery with cardiopulmonary bypass (CPB) is well described in literature, but the prevalence in pediatric Mexican population is yet unknown.OBJECTIVE: To know the prevalence of postoperative low free triiodothyronine level and the associated complications after cardiopulmonary bypass exposure in pediatric population in Mexico.MATERIAL AND METHODS: A sample of free triiodothyronine (FT3) blood was obtained in the early postoperative period of patients undergoing CPB heart surgery. Postoperative low FT3 level (PLFT3) was defined as any blood value under 2.9 pg/mL. Logistical regression models were used for analysis of independent variables, adjusted for complexity score (RACHS-1) and Aristotle Comprehensive Complexity Score.RESULTS. PLFT3 was present in 35.7% of the patients (n=109). Correlation with PLFT3 the following variables were observed: prolonged CPB time (p=0.001) prolonged aortic cross clamp (p=0.002) level of complexity of the surgery as measured by Aristotle ≥3 (p=0.001) and RACHS-1 ≥3 (p=0.021). Associated complications were: postoperative arrhythmias (p=0.008) extended intubation period (p=0.008) and higher infection rate (p=0.002).

Highlights

Low free triiodothyronine level in patients undergoing heart surgery with cardiopulmonary bypass (CPB) is well described in literature, but the prevalence in pediatric Mexican population is yet unknown
Postoperative low FT3 level (PLFT3) was present in 35.7% of the patients (n=109)
It is estimated that each year, almost 3,500 children under 5 years of age die from heart disease in our country.[1] score in order to categorize their surgical risk

Summary

MATERIAL AND METHODS

A total of 109 consecutive children undergoing congenital heart surgery with CPB were included in the study. Descriptive data such as population demographics and incidence of PLFT3 in different sub-groups, were expressed as proportions and means. Levels of FT3 and risk categories (RACHS-1 and Aristotle Complexity Score) were dichotomized and Chi-square test was used for the analysis. Continuous variables were reported as averages, using Mann Whitney test. Patients were classified according to the RACHS-1 score and Aristotle Comprehensive complexity. Logistical regression models were used for analysis of independent variables, which were. Adjusted for age, gender and complexity score (RACHS-1). Aortic cross clamp time (p=0.001) and cardiopulmonary bypass time (p=< 0.001). A p-value < 0.05 was considered significant

RESULTS

BACKGROUND

DISCUSSION