Đang chuẩn bị liên kết để tải về tài liệu:
Bóa cáo y học: "Clinical review: Thyroid hormone replacement in children after cardiac surgery – is it worth a try"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical review: Thyroid hormone replacement in children after cardiac surgery – is it worth a try? | Available online http ccforum.eom content 10 3 213 Review Clinical review Thyroid hormone replacement in children after cardiac surgery - is it worth a try Nikolaus A Haas1 2 Christoph K Camphausen1 and Deniz Kececioglu2 1 Paediatric Cardiac Intensive Care Unit The Prince Charles Hospital Brisbane Australia 2Department of Congenital Heart Defects Heart and Diabetes Centre Northrhein-Westfalia Bad Oeynhausen Germany Corresponding author Nikolaus A Haas Nikhaas@hdz-nrw.de Published 23 May 2006 This article is online at http ccforum.com content 10 3 213 2006 BioMed Central Ltd Critical Care 2006 10 213 doi 10.1186 cc4924 Abstract 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. Introduction During systemic illness especially after cardiac surgery using cardiopulmonary bypass CBP abnormalities in the circulating thyroid hormone levels are found in the absence of primary thyroid disease this is collectively called the sick euthyroid syndrome SES . Some argue that it is unclear if the clinical picture of SES is an adaptive process a marker of the severity of illness or even if .