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Suat Buket
Mustafa Ozbaran
Ahmet Hamulu
Berent Discigil
Isa Durmaz
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Ann Thorac Surg 1994;58:93-96
© 1994 The Society of Thoracic Surgeons

Articles

Effect of pulsatile flow during cardiopulmonary bypass on thyroid hormone metabolism

Suat Buket, MD, Alp Alayunt, MD, Mustafa Ozbaran, MD, Ahmet Hamulu, MD, Berent Discigil, MD, Bulent Cetindag, MD, Hayal Ozkilic, MD, Zehra Balkan, MD, Onol Bilkay, MD*, Isa Durmaz, MD

Department of Cardiovascular Surgery, Ege University Medical Faculty, Izmir, Turkey

Accepted for publication October 11, 1993.

* Address reprint requests to Dr Bilkay, Cardiovascular Surgery, Ege University Medical Faculty, Izmir, Turkey.

Changes in thyroid hormone levels during and after cardiopulmonary bypass (CPB) are well documented. However, little is known about the effects of pulsatile flow during CPB on thyroid hormone metabolism. To examine the effect of flow pattern, a prospective study was carried out using 30 patients undergoing coronary artery bypass grafting. Fifteen patients had pulsatile flow during CPB and 15, nonpulsatile flow. Serum samples were obtained preoperatively, during bypass, and at 2 and 24 hours postoperatively. Thyroid-stimulating hormone, thyroxine (T4), triiodothyronine (T3), free T4, and free T3 levels were measured by radioimmunoassay. All measured hormone levels except free T4 and thyroid-stimulating hormone decreased after the initiation of CPB. There were no differences in preoperative values between the two groups. However, levels of T3 and free T3 during and after CPB showed a significant difference between the two groups, with a smaller decrease in patients in whom pulsatile flow was used during bypass (p < 0.05). Thyroxine, and thyroid-stimulating hormone free T4 values showed no difference between the two groups at any sampling time. These data provide support for the use of pulsatile flow during CPB to establish a more physiologic state and maintain better thyroid hormone metabolism.




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