Preoperative management of patients with thyroid dysfunction who are candidates for CABG
Preoperative management of patients with thyroid dysfunction who are candidates for CABG
Mozhgan Karimifar
MD
Isfahan University of Medical Sciences
15 NOVEMBER 2018
- Thyroid disease is common; the prevalence is higher in women and with increasing age.
- Although most patients with well compensated thyroid disease do not need special consideration prior to surgery, patients who have a newly diagnosed thyroid disorder around the time of surgery require a discussion of the risks and benefits of proceeding with surgery.
Preoperative management of patients who are candidates for CABG and have:
- Hypothyroidism
- Hyperthyroidism
HYPOTHYROIDISM
Defining severity of hypothyroidism
- Severe hypothyroidism
- Moderate hypothyroidism
- Mild hypothyroidism
Severe hypothyroidism
Includes patients with:
myxedema coma
severe clinical symptoms of chronic hypothyroidism such as:
altered mentation
pericardial effusion
heart failure
very low levels of total thyroxine (T4) (eg, less than 1.0 mcg/dL) or free T4 (eg, less than 0.5 ng/dL).
- Weinberg AD, Brennan MD, Gorman CA, et al. Outcome of anesthesia and surgery in hypothyroid patients. Arch Intern Med 1983; 143:893.
- Bennett-Guerrero E, Kramer DC, Schwinn DA. Effect of chronic and acute thyroid hormone reduction on perioperative outcome. Anesth Analg 1997; 85:30.
