Al-Azhar Assiut Medical Journal (Jan 2017)

Thyroid hormones; plasma level in critical ill patients need prolonged mechanical ventilation

  • Abdelazim A.T Hegazy,
  • Essam A Mostafa,
  • Abdel N Ahmed Hussein

DOI
https://doi.org/10.4103/AZMJ.AZMJ_22_17
Journal volume & issue
Vol. 15, no. 2
pp. 92 – 96

Abstract

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Background Thyroid function usually downregulates during stressful conditions. Thyroid dysfunction is associated with the mortality of patients under mechanical ventilation (MV) in the ICU. Aim The aim of this study was to measure the thyroid hormonal level in the plasma of critical ill patients on prolonged MV. Patients and methods Fifty patients were participated and completed the present study. The thyroid hormones: thyroid stimulating hormone, tri-thyroxine (T3), tetra-thyroxine (T4), reverse tri-thyroxine (rT3), were collected from the plasma: and tested as follows. The first sample was collected just before initiation of MV; second sample 24 h after initiation of MV; third sample: 24 h after successful weaning from MV. Venous blood samples were collected from each patient in nonheparinized blood collecting tubes, and the samples were allowed to clot at room temperature. All samples were centrifuged within 2 h after withdrawal and stored at 20°C until assayed. Results The investigators have noticed that the patients, who were weaned off from MV in a period of less than 16 days, have good prognosis and who have been for a period of more than 16 days were classified as bad prognosis patients. Plasma levels of thyroid stimulating hormone, T4 and T3 in both good prognostic patients and bad prognostic patients were determined; there are clinical (died in bad group or survived in good prognosis group) and little mathematical difference between both groups, but of no significance statistically. The plasma level of rT3 in both good prognostic patients and bad prognostic patients has a high level in the second sample, and there are clinical and little mathematical difference between both groups but no significance statistically. Conclusion The study of the level of thyroid hormones can give an idea about the progress of management of critically ill patients who undergo prolonged MV.

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