Impact of thyroid hormone supplementation on postoperative care in patients with subclinical hypothyroidism following on-pump coronary bypass grafting surgery- A randomized controlled trial

This study investigates the impact of thyroid hormone supplementation on postoperative care for patients with subclinical hypothyroidism undergoing elective on-pump coronary artery bypass grafting (CABG) surgery. Subclinical hypothyroidism (SCH) is characterized by elevated TSH levels with normal thyroid hormone levels, which can affect cardiac function and recovery after surgery. The study aims to assess whether thyroid supplementation improves postoperative outcomes, particularly ICU stay duration, mechanical ventilation time, and the incidence of arrhythmias.

The study is a randomized controlled trial conducted at AIIMS Jodhpur, involving patients between 18 and 80 years undergoing elective CABG. Patients are divided into two groups: one group receives thyroid hormone supplementation (levothyroxine and liothyronine), while the other does not. The primary objective is to evaluate the impact of thyroid supplementation on ICU stay, with secondary objectives including assessing mechanical ventilation time, hospital stay, arrhythmias, and need for inotropic support.

The study uses a sample size of 82 patients, considering feasibility within the time constraints. Data is collected on preoperative, intraoperative, and postoperative variables, including TSH levels, inflammatory markers, and postoperative complications. Statistical analysis will be performed using multivariable logistic regression and Cox proportional hazards regression to compare the two groups.Ethically, the study will be conducted after obtaining patient consent, with the potential to update clinical practices and improve postoperative care for this group of patients. If successful, thyroid supplementation may shorten ICU stay, reduce the need for inotropes, and enhance recovery outcomes after CABG surgery.