Cardiopulmonary bypass

‘a low T4 and T3 syndrome’ with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH)

Giuseppe Robuschi, Dante Medici, Francesco Fesani, Guglielmo Barboso, Mara Montermini, Lorenzo D’Amato, Eliana Gardini, Elisabetta Borciani, Elisabetta Dallaglio, Mario Salvi, Angelo Gnudi, Elio Roti

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Thyroid hormone serum concentrations, the thyrotropin (TSH) and prolactin (PRL) response to thyrotropin-releasing hormone (TRH) were evaluated in patients undergoing cardiopulmonary bypass (CPB) conducted in hypothermia. During CPB a marked decrease of thyroxine (T4) and triiodothyronine (T3) concentration with a concomitant increase of reverse T3 (rT3) were observed similarly to other clinical states associated with the ‘low T3 syndrome’. Furthermore, in the present study elevated FT4 and FT3 concentrations were observed. In a group of patients, TRH administered during CPB at 26 °C elicited a markedly blunted TSH response. In these patients, PRL concentration was elevated but did not significantly increase after TRH. The increased concentrations of FT4 and FT3 were probably due to the large doses of heparin administered to these patients. Thus, the blunted response of TSH to TRH might be the consequence of the elevation of FT4 and FT3 in serum, however, other factors might play a role since also the PRL response to TRH was blocked.

Original languageEnglish
Pages (from-to)151-158
Number of pages8
JournalHormone Research in Paediatrics
Volume23
Issue number3
DOIs
Publication statusPublished - 1986

Fingerprint

Euthyroid Sick Syndromes
Thyrotropin-Releasing Hormone
Thyrotropin
Cardiopulmonary Bypass
Prolactin
Triiodothyronine
Hypothermia
Serum
Thyroxine
Thyroid Hormones
Heparin

Keywords

  • Cardiosurgery
  • FT<inf>3</inf>
  • Ft<inf>4</inf>
  • PRL response to TRH
  • RT<inf>3</inf>
  • T<inf>3</inf>
  • T<inf>4</inf>
  • Tsh

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

Cite this

Cardiopulmonary bypass : ‘a low T4 and T3 syndrome’ with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH). / Robuschi, Giuseppe; Medici, Dante; Fesani, Francesco; Barboso, Guglielmo; Montermini, Mara; D’Amato, Lorenzo; Gardini, Eliana; Borciani, Elisabetta; Dallaglio, Elisabetta; Salvi, Mario; Gnudi, Angelo; Roti, Elio.

In: Hormone Research in Paediatrics, Vol. 23, No. 3, 1986, p. 151-158.

Research output: Contribution to journalArticle

Robuschi, G, Medici, D, Fesani, F, Barboso, G, Montermini, M, D’Amato, L, Gardini, E, Borciani, E, Dallaglio, E, Salvi, M, Gnudi, A & Roti, E 1986, 'Cardiopulmonary bypass: ‘a low T4 and T3 syndrome’ with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH)', Hormone Research in Paediatrics, vol. 23, no. 3, pp. 151-158. https://doi.org/10.1159/000180311
Robuschi, Giuseppe ; Medici, Dante ; Fesani, Francesco ; Barboso, Guglielmo ; Montermini, Mara ; D’Amato, Lorenzo ; Gardini, Eliana ; Borciani, Elisabetta ; Dallaglio, Elisabetta ; Salvi, Mario ; Gnudi, Angelo ; Roti, Elio. / Cardiopulmonary bypass : ‘a low T4 and T3 syndrome’ with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH). In: Hormone Research in Paediatrics. 1986 ; Vol. 23, No. 3. pp. 151-158.
@article{ab1cfe20fea24b9c9985353f21af35c0,
title = "Cardiopulmonary bypass: ‘a low T4 and T3 syndrome’ with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH)",
abstract = "Thyroid hormone serum concentrations, the thyrotropin (TSH) and prolactin (PRL) response to thyrotropin-releasing hormone (TRH) were evaluated in patients undergoing cardiopulmonary bypass (CPB) conducted in hypothermia. During CPB a marked decrease of thyroxine (T4) and triiodothyronine (T3) concentration with a concomitant increase of reverse T3 (rT3) were observed similarly to other clinical states associated with the ‘low T3 syndrome’. Furthermore, in the present study elevated FT4 and FT3 concentrations were observed. In a group of patients, TRH administered during CPB at 26 °C elicited a markedly blunted TSH response. In these patients, PRL concentration was elevated but did not significantly increase after TRH. The increased concentrations of FT4 and FT3 were probably due to the large doses of heparin administered to these patients. Thus, the blunted response of TSH to TRH might be the consequence of the elevation of FT4 and FT3 in serum, however, other factors might play a role since also the PRL response to TRH was blocked.",
keywords = "Cardiosurgery, FT<inf>3</inf>, Ft<inf>4</inf>, PRL response to TRH, RT<inf>3</inf>, T<inf>3</inf>, T<inf>4</inf>, Tsh",
author = "Giuseppe Robuschi and Dante Medici and Francesco Fesani and Guglielmo Barboso and Mara Montermini and Lorenzo D’Amato and Eliana Gardini and Elisabetta Borciani and Elisabetta Dallaglio and Mario Salvi and Angelo Gnudi and Elio Roti",
year = "1986",
doi = "10.1159/000180311",
language = "English",
volume = "23",
pages = "151--158",
journal = "Hormone Research in Paediatrics",
issn = "1663-2818",
publisher = "S. Karger AG",
number = "3",

}

TY - JOUR

T1 - Cardiopulmonary bypass

T2 - ‘a low T4 and T3 syndrome’ with blunted thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH)

AU - Robuschi, Giuseppe

AU - Medici, Dante

AU - Fesani, Francesco

AU - Barboso, Guglielmo

AU - Montermini, Mara

AU - D’Amato, Lorenzo

AU - Gardini, Eliana

AU - Borciani, Elisabetta

AU - Dallaglio, Elisabetta

AU - Salvi, Mario

AU - Gnudi, Angelo

AU - Roti, Elio

PY - 1986

Y1 - 1986

N2 - Thyroid hormone serum concentrations, the thyrotropin (TSH) and prolactin (PRL) response to thyrotropin-releasing hormone (TRH) were evaluated in patients undergoing cardiopulmonary bypass (CPB) conducted in hypothermia. During CPB a marked decrease of thyroxine (T4) and triiodothyronine (T3) concentration with a concomitant increase of reverse T3 (rT3) were observed similarly to other clinical states associated with the ‘low T3 syndrome’. Furthermore, in the present study elevated FT4 and FT3 concentrations were observed. In a group of patients, TRH administered during CPB at 26 °C elicited a markedly blunted TSH response. In these patients, PRL concentration was elevated but did not significantly increase after TRH. The increased concentrations of FT4 and FT3 were probably due to the large doses of heparin administered to these patients. Thus, the blunted response of TSH to TRH might be the consequence of the elevation of FT4 and FT3 in serum, however, other factors might play a role since also the PRL response to TRH was blocked.

AB - Thyroid hormone serum concentrations, the thyrotropin (TSH) and prolactin (PRL) response to thyrotropin-releasing hormone (TRH) were evaluated in patients undergoing cardiopulmonary bypass (CPB) conducted in hypothermia. During CPB a marked decrease of thyroxine (T4) and triiodothyronine (T3) concentration with a concomitant increase of reverse T3 (rT3) were observed similarly to other clinical states associated with the ‘low T3 syndrome’. Furthermore, in the present study elevated FT4 and FT3 concentrations were observed. In a group of patients, TRH administered during CPB at 26 °C elicited a markedly blunted TSH response. In these patients, PRL concentration was elevated but did not significantly increase after TRH. The increased concentrations of FT4 and FT3 were probably due to the large doses of heparin administered to these patients. Thus, the blunted response of TSH to TRH might be the consequence of the elevation of FT4 and FT3 in serum, however, other factors might play a role since also the PRL response to TRH was blocked.

KW - Cardiosurgery

KW - FT<inf>3</inf>

KW - Ft<inf>4</inf>

KW - PRL response to TRH

KW - RT<inf>3</inf>

KW - T<inf>3</inf>

KW - T<inf>4</inf>

KW - Tsh

UR - http://www.scopus.com/inward/record.url?scp=0022620261&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0022620261&partnerID=8YFLogxK

U2 - 10.1159/000180311

DO - 10.1159/000180311

M3 - Article

VL - 23

SP - 151

EP - 158

JO - Hormone Research in Paediatrics

JF - Hormone Research in Paediatrics

SN - 1663-2818

IS - 3

ER -