Department of Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing, 210006, People's Republic of China.
Department of Orthopedics, Nanjing Yuhua Hospital, Nanjing, 210006, People's Republic of China.
BMC Anesthesiol. 2022 Mar 9;22(1):66. doi: 10.1186/s12871-022-01608-6.
This study aimed to examine the correlation between thyroid hormone and prolonged mechanical ventilation (MV) in adult critically ill patients having undergone cardiac surgery.
The present study refers to a retrospective, cohort study conducted at Nanjing First Hospital from March 2019 to December 2020. Patients receiving cardiac surgery and admitting to the Cardiovascular Intensive Care Unit (CVICU) in the study period were screened for potential inclusion. Demographic information, thyroid hormone and other laboratory measurements and outcome variables were recorded for analysis. Prolonged MV was defined as the duration of MV after cardiac surgery longer than 5 days. Thyroid hormones were assessed for the prognostic significance for prolonged MV.
One thousand eight hundred ninety-six patients who underwent cardiac surgery were screened for potential enrollment. Overall, 118 patients were included and analyzed in this study. Patients fell to the control (n = 64) and the prolonged MV group (n = 54) by complying with the duration of MV after cardiac surgery. The median value of total triiodothyronine (TT3) and free triiodothyronine (FT3) were 1.03 nmol/L and 3.52 pmol/L in the prolonged MV group before cardiac surgery, significantly lower than 1.23 nmol/L (P = 0.005) and 3.87 pmol/L, respectively in control (P = 0.038). Multivariate logistic regression analysis indicated that TT3 before surgery (pre-op TT3) had an excellent prognostic significance for prolonged MV (OR: 0.049, P = 0.012).
This study concluded that decreased triiodothyronine (T3) could be common in cardiac patients with prolonged MV, and it would be further reduced after patients undergo cardiac surgery. Besides, decreased T3 before surgery could act as an effective predictor for prolonged MV after cardiac surgery.
本研究旨在探讨甲状腺激素与成人心脏手术后行机械通气（MV）时间延长的相关性。
本研究为回顾性队列研究，于 2019 年 3 月至 2020 年 12 月在南京第一医院进行。筛选出在研究期间接受心脏手术并入住心血管重症监护病房（CVICU）的患者，记录其人口统计学信息、甲状腺激素和其他实验室测量值以及结局变量，以分析甲状腺激素与 MV 时间延长的相关性。MV 时间延长定义为心脏手术后 MV 时间超过 5 天。评估甲状腺激素对 MV 时间延长的预后意义。
筛选出 1896 例接受心脏手术的患者，其中 118 例符合纳入标准并进行分析。根据心脏手术后 MV 时间，患者分为对照组（n=64）和 MV 时间延长组（n=54）。MV 时间延长组术前总三碘甲状腺原氨酸（TT3）和游离三碘甲状腺原氨酸（FT3）的中位数分别为 1.03 nmol/L 和 3.52 pmol/L，显著低于对照组的 1.23 nmol/L（P=0.005）和 3.87 pmol/L（P=0.038）。多因素 logistic 回归分析表明，术前 TT3（pre-op TT3）对 MV 时间延长具有良好的预后意义（OR：0.049，P=0.012）。
该研究表明，甲状腺功能减退症（T3 降低）在心脏手术后 MV 时间延长的患者中较为常见，且在心脏手术后进一步降低。此外，术前 T3 降低可作为心脏手术后 MV 时间延长的有效预测指标。
