Haas Nikolaus A, Camphausen Christoph K, Kececioglu Deniz
Paediatric Cardiac Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia.
Crit Care. 2006;10(3):213. doi: 10.1186/cc4924. Epub 2006 May 23.
Cardiac surgery using cardiopulmonary bypass produces a generalized systemic inflammatory response, resulting in increased postoperative morbidity and mortality. Under these circumstances, a typical pattern of thyroid abnormalities is seen in the absence of primary disease, defined as sick euthyroid syndrome (SES). The presence of postoperative SES mainly in small children and neonates exposed to long bypass times and the pharmacological profile of thyroid hormones and their effects on the cardiovascular physiology make supplementation therapy an attractive treatment option to improve postoperative morbidity and mortality. Many studies have been performed with conflicting results. In this article, we review the important literature on the development of SES in paediatric postoperative cardiac patients, analyse the existing information on thyroid hormone replacement therapy in this patient group and try to summarize the findings for a recommendation.
使用体外循环的心脏手术会引发全身性炎症反应，导致术后发病率和死亡率增加。在这种情况下，在无原发性疾病时会出现典型的甲状腺异常模式，即所谓的“病态正常甲状腺综合征”（SES）。术后SES主要出现在经历长时间体外循环的小儿和新生儿中，甲状腺激素的药理学特性及其对心血管生理的影响使得补充疗法成为改善术后发病率和死亡率的一种有吸引力的治疗选择。许多研究已经开展，但结果相互矛盾。在本文中，我们回顾了关于小儿心脏术后患者SES发生的重要文献，分析了该患者群体甲状腺激素替代疗法的现有信息，并试图总结研究结果以给出建议。
