Cardiothoracic & vascular anesthesia
Early Enteral Levothyroxine as Rescue Therapy in Cardiac Surgery Patients With Delayed Neurologic Recovery: A Randomized Trial
Primary result · Change in GCS scoreResult — go to the resultAdjusted mean difference +7.81 95% CI 5.24–10.38Authors' conclusion
Early enteral levothyroxine administration in cardiac surgery patients with delayed postoperative recovery was associated with significantly accelerated neurologic recovery and improved cardiac function.
Study context
- Population
- Adults after on-pump cardiac surgery with delayed recovery (mechanical ventilation >48 hours or Glasgow Coma Scale (GCS) <15 at 48 hours postoperatively)
- Participants
- 70 adults
- Comparison
- Enteral levothyroxine vs placebo
- Levothyroxinen = 35
- Primary endpoint
- Change in GCS score from intervention initiation (48 hours postoperatively) to ICU discharge
- Follow-up
- ICU discharge
Methodological detailssingle-centre, double-blind, placebo-controlled
- Single-centre
- Double-blind
- Placebo-controlled
Primary result
Change in GCS score
Adjusted mean difference
+7.81
95% CI 5.24–10.38
P < 0.001
As reported in the abstract
- Faster recovery rate with levothyroxine (p < 0.001)
- 128%
Secondary outcomes
| Outcome | Levothyroxine | Placebo | aHR (95% CI) | P value | |
|---|---|---|---|---|---|
| 30-day mortality | 14.3% | 45.7% | 0.24 (0.09–0.65) | P = 0.005 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Hospital LOS · attributed to survivorship bias
- 30-day mortality: small number of events (n = 21); exploratory
- Hospital LOS: p = 0.005
Neurologic recovery rate
- 128% faster recovery rate with levothyroxine
- p < 0.001
Cardiac function (ejection fraction)
- Cardiac function improved (attenuated ejection fraction decline); aMD
- +12.99%
- p < 0.001
Catecholamine requirements
- Lower catecholamine needs
- 41% to 63%
- p ≤ 0.01
Thyroid hormone levels
- GCS score gain per 1-pg/mL increase in free triiodothyronine
- 2.1-point
- Levothyroxine normalized thyroid hormone levels
- p < 0.001
Original publication
Early Enteral Levothyroxine as Rescue Therapy in Cardiac Surgery Patients With Delayed Neurologic Recovery: A Randomized Trial. J Cardiothorac Vasc Anesth. Published 11 May 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →