Thyroid Response to Cardiopulmonary Bypass in Children with Congenital Heart Disease: A Literature Review
Irvine Iraudi Putri1, Heroe Soebroto2*, Taufiq Hidayat3, Arief Rakhman Hakim2
Abstract
Congenital heart disease (CHD) correction frequently requires open-heart surgery with cardiopulmonary bypass (CPB), a procedure that can trigger hormonal disruption and hemodynamic instability. CPB is known to cause Non-Thyroidal Illness Syndrome (NTIS) through decreased perfusion, hemodilution, and the release of inflammatory cytokines that suppress the hypothalamic-pituitary-thyroid axis. This literature review aims to describe the mechanisms of thyroid response to CPB in children with CHD and their association with postoperative outcomes. A search of six databases (2010–2025) yielded six relevant studies. All studies demonstrated significant decreases in T3, T4, and TSH within 24–48 hours postoperatively, particularly in neonates and in patients undergoing high-complexity procedures. These changes are associated with increased inotropic requirements, the risk of low cardiac output syndrome, longer ventilation duration, and length of ICU stay. This confirms that CPB significantly impacts thyroid function and hemodynamic stability in children, requiring careful postoperative clinical and hormonal monitoring to minimize the risk of complications. Thyroid hormone supplementation may help stabilize levels, although its benefits on primary outcomes remain inconsistent.
Keywords
congenital heart disease; cardiopulmonary bypass; aortic cross-clamping; thyroid-stimulating hormone; pediatric; cardiac surgery
Cite This Article
Putri, I. I., Soebroto, H., Hidayat, T., Hakim, A. R. (2025). Thyroid Response to Cardiopulmonary Bypass in Children with Congenital Heart Disease: A Literature Review. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 6: Nov – Dec 2025, Pages 1165-1170 URL: https://www.ijscia.com/wp-content/uploads/2025/12/Volume6-Issue6-Nov-Dec-No.991-1165-1170.pdf
Volume 6 | Issue 6: Nov – Dec 2025
