The identification of thyroid dysfunction in surgical sepsis
S Rob Todd1, Vasiliy Sim, Laura J Moore
1Department of Surgery, New York University Langone Medical Center, New York, New York, USA. srtodd@nyumc.org
The Journal of Trauma and Acute Care Surgery
|November 29, 2012
Summary
In surgical sepsis, lower triiodothyronine (T3) levels at baseline indicate a higher risk of mortality. While thyroxine (T4) is elevated, T3 replacement may be beneficial in critically ill patients.
Area of Science:
- Endocrinology
- Critical Care Medicine
- Sepsis Research
Background:
- Hypothyroxinemia is linked to mortality in critically ill patients.
- Limited data exist on thyroid function in sepsis.
- This study investigates thyroid function in surgical sepsis.
Purpose of the Study:
- To assess baseline thyroid function tests in surgical sepsis.
- To determine the association between thyroid hormones and mortality.
- To evaluate the potential for thyroid hormone replacement therapy.
Main Methods:
- Retrospective review of prospectively collected data.
- Analysis of 231 surgical sepsis patients.
- Evaluation of demographics, thyroid function (T3, free T4, TSH), and mortality.
Main Results:
- No significant differences in T3, free T4, or TSH across sepsis severity.
- Free thyroxine (T4) levels were elevated but lower in non-survivors.
- Triiodothyronine (T3) levels were significantly decreased in patients who died.
Conclusions:
- Decreased baseline T3 levels are associated with mortality in surgical sepsis.
- Elevated T4 levels do not support levothyroxine (T4) administration.
- Liothyronine (T3) replacement may be a rational therapeutic approach.
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