CONTEXT: Effects of thyroid hormone therapy on postoperative morbidity and 
mortality in adults remain controversial.
OBJECTIVE: The aim was to conduct a systematic review evaluating effects and 
risks of postoperative T(3) therapy in adults.
DATA SOURCES: Electronic databases and reference lists through March 2010 were 
searched.
STUDY SELECTION: Studies with comparable control groups comparing T(3) to 
placebo therapy in randomized controlled trials were selected.
DATA EXTRACTION: Two reviewers independently screened and reviewed titles, 
abstracts, and articles. Data were abstracted from 14 randomized controlled 
trials (13 cardiac surgery and one renal transplantation). In seven studies, iv 
T(3) was given in high doses (0.175-0.333 μg/kg · h) for 6 to 9 h, in four 
studies iv T(3) was given in low doses (0.0275-0.0333 μg/kg · h for 14 to 24 h), 
and in three studies T(3) was given orally in variable doses and durations.
DATA SYNTHESIS: Both high- and low-dose iv T(3) therapy increased cardiac index 
after coronary artery bypass surgery. Mortality was not significantly altered by 
high-dose iv T(3) therapy and could not be assessed for low-dose iv or oral 
T(3). Effects on systemic vascular resistance, heart rate, pulmonary capillary 
wedge pressure, new onset atrial fibrillation, inotrope use, serum TSH and T(4) 
were inconclusive.
LIMITATIONS: Numbers of usable unique studies and group sizes were small. 
Duration of T(3) therapy was short, and dosages and routes of administration 
varied.
CONCLUSIONS: Short duration postoperative iv T(3) therapy increases cardiac 
index and does not alter mortality. Effects on other parameters are 
inconclusive.