Non-thyroid disorders may modify
thyroid hormone metabolism, resulting in an '
euthyroid sick syndrome'. Studies determining the association of
cardiopulmonary bypass to thyroid function showed changes in line with this
euthyroid sick syndrome. In some cases, cardiovascular dysfunction after cardiac surgery with
cardiopulmonary bypass is comparable to that noticed in
hypothyroidism associated with
low cardiac output and elevated systemic vascular resistance. Numerous lines of research have proposed that
triiodothyronine can behave acutely as a positive inotropic and
vasodilator agent. The aim of this review is to present an update on the current literature about in what clinical situations the use of thyroid supplementation during the
perioperative period of
extracorporeal circulation in the adult and paediatric populations may impact outcome to any appreciable degree. The contribution of thyroid function in patients undergoing a
ventricular assist device implantation is additionally reviewed and future study directions are proposed. This is a narrative review, where the search strategy consisted on retrieving the articles through an extensive literature search performed using electronic databases from January 1978 up to September 2019. All controlled trials randomly allocating to perioperative
thyroid hormone administration in children and adults undergoing
extracorporeal circulation for cardiac surgery were considered.
Thyroid hormone supplementation may be recommended particularly in selected paediatric sub-populations. There is currently no firm evidence regarding the benefits of routine use of
thyroid hormone administration in cardiac adult patients. Further studies are required to assess the beneficial effect of
thyroid hormone on patients with end-stage
heart failure supported by
ventricular assist devices.