Eva M. Marwali, MD, PhD, Cindy E

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Presentation transcript:

Oral Triiodothyronine for Infants and Children Undergoing Cardiopulmonary Bypass Eva M. Marwali, MD, PhD, Cindy E. Boom, MD, PhD, Novik Budiwardhana, MD, Dicky Fakhri, MD, PhD, Poppy S. Roebiono, MD, Anwar Santoso, MD, PhD, Sudigdo Sastroasmoro, MD, PhD, April Slee, MS, Michael A. Portman, MD The Annals of Thoracic Surgery Volume 104, Issue 2, Pages 688-695 (August 2017) DOI: 10.1016/j.athoracsur.2017.01.001 Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Flow diagram for patient allocation and analysis. (CPB = cardiopulmonary bypass; ITT = intention-to-treat; mITT = modified intention-to-treat; T3 = triiodothyronine; TTE = time to extubation.) The Annals of Thoracic Surgery 2017 104, 688-695DOI: (10.1016/j.athoracsur.2017.01.001) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Numbers of patients in subgroup (A) aged ≤5 months and (B) >5 months for each cardiac diagnosis. (CAVC = complete atrioventricular canal; CoA = coarctation of the aorta; IAA = interrupted of aortic arch; PAPVC = partial anomalous pulmonary venous connection; PAVC = partial atrioventricular canal; TAPVC = total anomalous pulmonary venous connection; TOF = tetralogy of Fallot; VSD = ventricular septal defect.) The Annals of Thoracic Surgery 2017 104, 688-695DOI: (10.1016/j.athoracsur.2017.01.001) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Serial measurements of blood free triiodothyronine (FT3) levels (placebo vs drug). The arrows indicate the time when the drug was given (beginning at induction of anesthesia and then every 6 hours for a total of 11 doses). Data are shown as the least squares mean and 95% confidence interval (range bars). The normal range for FT3 is 2.5 to 6.8 pg/mL [15]. The p values are from mixed models for repeated measures, adjusted for age category, Aristotle score, and Z score. The Annals of Thoracic Surgery 2017 104, 688-695DOI: (10.1016/j.athoracsur.2017.01.001) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Serial measurements of blood thyroid-stimulating hormone (TSH) levels (placebo vs drug). Data are shown as least squares mean and 95% confidence interval (range bar). The lowest normal level for TSH is 0.85 μIU/mL [15]. The p values are from mixed models for repeated measures, adjusted for age category, Aristotle score, and Z score. The Annals of Thoracic Surgery 2017 104, 688-695DOI: (10.1016/j.athoracsur.2017.01.001) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Kaplan-Meier curve of time to extubation (TTE) in placebo (Pbo) vs drug in (A) modified intention to treat (mITT) population and (B) by age strata. Longer TTE was showed in the 75th percentile of TTE in placebo compared with triiodothyronine. Number and percentage of patients who remained intubated after cross-clamp removal day are shown below panel A. Hazard ratio (HR), 95% confidence interval (CI), and p values were derived from Cox regression models adjusted for age category, Aristotle score, and Z score. The stratified log-rank p value is presented for comparison and does not indicate a statistically significant difference between groups for the entire cohort. The Annals of Thoracic Surgery 2017 104, 688-695DOI: (10.1016/j.athoracsur.2017.01.001) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions

Supplemental Figure 1 The Annals of Thoracic Surgery 2017 104, 688-695DOI: (10.1016/j.athoracsur.2017.01.001) Copyright © 2017 The Society of Thoracic Surgeons Terms and Conditions