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Thyroid function in the critically ill newborn and child

Judy L Shih1, Michael S D Agus

  • 1Medicine Critical Care Program, Department of Medicine, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts, USA.

Current Opinion in Pediatrics
|May 19, 2009
PubMed

Insights

Thyroid function abnormalities are common in critically ill children, similar to adults. Current evidence does not support thyroid hormone therapy for nonthyroidal illness in these pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine
  • Thyroid Physiology

Background:

  • Critically ill children often exhibit altered thyroid function.
  • These alterations involve the hypothalamic-pituitary-thyroid axis.
  • Prevalence is similar in pediatric and adult populations.

Purpose of the Study:

  • To review typical thyroid function alterations in critically ill pediatric patients.
  • To assess the current evidence for thyroid hormone therapy in this population.

Main Methods:

  • Literature review of studies on pediatric critical illness and thyroid function.
  • Analysis of data on hypothalamic-pituitary-thyroid axis abnormalities.
  • Evaluation of therapeutic benefits of thyroid hormone supplementation.

Main Results:

  • Thyroid function abnormalities are prevalent in critically ill children.
  • These abnormalities mirror those seen in adult patients.
  • No significant benefits of thyroid hormone therapy have been demonstrated.

Conclusions:

  • No evidence supports thyroid hormone administration for nonthyroidal illness in critically ill children.
  • This includes preterm infants and postcardiac surgery patients with low T3 or T4.
  • Further research is needed to clarify the role of thyroid hormones in pediatric critical illness.
Abstract

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