Triiodothyronine Supplementation for Children Undergoing Cardiopulmonary Bypass: A Meta-Analysis

AbstractSpecific pediatric populations have exhibited disparate responses to triiodothyronine (T3) repletion during and after cardiopulmonary bypass (CPB). Objective: To determine if T3 supplementation improves outcomes in children undergoing CPB. We searched randomized controlled trials (RCT) evaluating T3 supplementation in children aged 0 –3 years undergoing CPB between 1/1/2000 and 1/31/2022. We calculated Hazard ratios (HR) for time to extubation (TTE), ICU length of stay (LOS), and hospital LOS. 5 RCTs met inclusion criteria with available patient-level data. Two were performed in United States (US) and 3 in Indonesia with 767 total subjects (range 29- 220). Median (IQR) age 4.1 (1.6, 8.0) months; female 43%; RACHS-1 scores: 1–1%; 2–55%; 3–27%; 4–13%; 5–0.1%; 6–3.9%; 54% of subjects in US vs 46% in Indonesia. Baseline TSH and T3 were lower in Indonesia (p <  0.001). No significant difference occurred in TTE between treatment groups overall [HR 1.09 (CI, 0.94–1.26)]. TTE numerically favored T3-treated patients aged 1–5 months [HR 1.24 (CI, 0.97–1.60)]. TTE HR for the Indonesian T3 group was 1.31 (CI, 1.04–1.65) vs. 0.95 (CI, 0.78–1.15) in U S. The ICU LOS HR for the Indonesian T3 group was 1.19 vs. 0.89 in US (p = 0.046). There was a significant T3 effect on hospital LOS [HR 1.30 (CI, 1.01–1.67)] in Indonesia but not in US [HR 0.99 (CI, 0.78–1.23)]. T3 supplementation in children undergoing CPB is simple, inexpensive, and safe, sh...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research