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Thyroid Hormone Profile in Children with Sepsis: Does Euthyroid Sick Syndrome Exist?

Gema Nazri Yanni1, Cynthea Prima Destariani1, Arlina Nurbaity Lubis1

  • 1Department of Child Health, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia.

Open Access Macedonian Journal of Medical Sciences
|May 4, 2019
PubMed

Insights

In pediatric sepsis, thyroid hormone levels (T3 and T4) decrease, indicating Euthyroid Sick Syndrome. Lower thyroid hormone levels on day 1 are significantly linked to poorer patient outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Critical Care Medicine
  • Sepsis Pathophysiology

Background:

  • Altered peripheral thyroid hormone metabolism is implicated in Euthyroid Sick Syndrome.
  • Changes in thyroid hormones due to altered solvation are noted.
  • Data on thyroid hormones in critically ill children are limited.

Purpose of the Study:

  • To evaluate the thyroid hormone profile in children diagnosed with sepsis.
  • To assess the association between thyroid hormone levels and sepsis outcomes in pediatric patients.

Main Methods:

  • An observational cohort study included 80 children with sepsis.
  • Thyroid hormone levels (T3 and T4) were measured on day 1 and after 72 hours of sepsis diagnosis.
  • Statistical analysis, including the chi-square test, was used to analyze relationships with patient outcomes and length of stay.

Main Results:

  • Thyroid hormone levels (T3 and T4) were decreased on day 1 in pediatric sepsis patients.
  • A significant relationship was found between T3 and T4 levels on day 1 and patient outcome (P=0.0001; OR 24.706 for T3, P=0.014; OR 3.086 for T4).
  • Patients with normal T3 and T4 levels had significantly higher chances of survival compared to those with lower levels.

Conclusions:

  • Euthyroid Sick Syndrome is present in pediatric sepsis.
  • Initial T3 and T4 levels in pediatric sepsis are significantly correlated with patient outcomes.
Abstract

Keywords:
ChildrenSepsisThyroid hormone

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