Thyroid hormone alterations in trauma patients requiring massive transfusion: An observational study

Area of Science:

• Endocrinology
• Trauma Medicine
• Critical Care

Background:

• Non-thyroidal illness syndrome (NTIS) is a known negative prognostic factor.
• Alterations in free triiodothyronine (fT3) in trauma patients with massive transfusions are not well-documented.

Purpose of the Study:

• To investigate fT3 levels in trauma patients requiring massive transfusions.
• To compare thyroid hormone levels and prognosis between massive transfusion and non-massive transfusion trauma patients.

Main Methods:

• Prospective observational study comparing two trauma patient groups: massive transfusion (Group M) and non-massive transfusion (Group C).
• Measured fT3, free thyroxine (fT4), and thyroid-stimulating hormone (TSH) on admission and days 1, 2, and 7.
• Compared clinical characteristics, transfusion amounts, and prognosis between groups.

Main Results:

• Nineteen patients in each group; mean age 50±24 years, 32 males.
• Group M had significantly lower initial fT3 levels (1.95±0.37 pg/mL) compared to Group C (2.49±0.72 pg/mL; P<0.01), persisting for 1 week.
• Initial fT4 and TSH levels did not differ significantly between groups; TSH increased in Group C by day 7 (P<0.05).

Conclusions:

• Trauma patients requiring massive transfusions exhibit typical NTIS.
• NTIS was observed in massive transfusion trauma patients, but prognosis was not strongly associated with NTIS after circulatory stabilization.