Serum thyroid hormone profile in critically Ill children

To study thyroid hormone profile in critically ill children and its correlation to disease severity and clinical outcome.

Total serum triiodothyronine (T3), thyroxine (T4) and TSH were estimated at admission and discharge from PICU/ just before death.

Mean T3 levels in cases were significantly lower than controls and lower in patients who expired, both at admission and just prior to death. Mean T4 levels were lower in cases, and just prior to death. Mean TSH levels were not different in cases and controls; or in survived and expired cases. When both T3 and T4 are low, mortality risk increases 30 times. Serum T3, T4 and TSH values improved in patients who survived unlike in those who expired. Age, sex, duration of hospital stay, ventilation, inotropic support, and PICU stay did not show any correlation with patient outcome or thyroid hormone profile. PRISM score at 24 hours and T4 levels in the second sample were significant predictors of survival.

T3 levels reflect the patient's clinical status, T4 levels can predict survival.