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[Changes in the hypophyseal-thyroid axis and their prognostic value in sepsis]
A Mangas-Rojas1, J F García-Rojas, A Barba Chacón
1Departamento de Medicina Interna, Facultad de Medicina de Cádiz.
Revista Clinica Espanola
|November 1, 1990
Summary
Thyroid hormone levels, specifically tri-iodine-thyronine (T3) and reverse tri-iodine-thyronine (rT3), can help predict sepsis outcomes. Low T3 levels (<35 ng/dl) indicate a higher risk of unfavorable sepsis evolution.
Area of Science:
- Endocrinology
- Critical Care Medicine
- Clinical Chemistry
Background:
- Sepsis significantly impacts thyroid hormone metabolism.
- Understanding thyroid function alterations is crucial for sepsis management and prognosis.
Purpose of the Study:
- To evaluate the prognostic value of serum thyroid hormone concentrations in sepsis patients.
- To determine the most useful thyroid function parameters for assessing sepsis severity.
Main Methods:
- Serum levels of thyroxine (T4), tri-iodine-thyronine (T3), reverse tri-iodine-thyronine (rT3), thyrotropin (TSH), and free thyroxine index (IT4L) were measured.
- 37 sepsis patients were divided into favorable (Group A) and fatal (Group B) outcome groups, alongside 14 healthy controls.
- Follow-up measurements were conducted on subsets of patients from both groups.
Main Results:
- Sepsis patients exhibited decreased T3 and increased rT3 levels, alongside a reduced IT4L, irrespective of outcome.
- No significant changes were observed in T4 and TSH levels.
- A T3 level below 35 ng/dl demonstrated the highest discriminative efficacy for predicting unfavorable sepsis evolution.
Conclusions:
- Serum T3 and rT3 levels are significantly altered in sepsis.
- Thyroid hormone profiles, particularly T3, hold prognostic value in sepsis.
- Monitoring T3 levels may aid in identifying patients at risk for poor outcomes.