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Thyroid function in severely traumatized patients with or without head injury.

R L Chioléro1, T Lemarchand-Béraud, Y Schutz

  • 1Department of Anaesthesiology, Lausanne University, Switzerland.

Acta Endocrinologica
|January 1, 1988
PubMed
Summary

Severe trauma causes a low thyroid hormone syndrome (low T3 and low T4). Head injury worsens these thyroid function changes, impacting survival rates in critically ill patients.

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Area of Science:

  • Endocrinology
  • Trauma Medicine
  • Critical Care

Background:

  • Thyroid dysfunction is common in critically ill patients.
  • The impact of severe trauma, particularly head injury, on thyroid function requires further elucidation.

Purpose of the Study:

  • To prospectively assess thyroid function changes in severe trauma patients.
  • To compare thyroid function patterns between patients with and without severe head injury.

Main Methods:

  • Prospective study of 35 severe trauma patients over 5 days post-injury.
  • Categorization into two groups: severe head injury vs. multiple injuries without head injury.
  • Measurement of total and free T3, T4, reverse T3 (rT3), and thyroid-stimulating hormone (TSH) levels.

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Main Results:

  • A consistent low T3 and low T4 syndrome was observed in all trauma patients.
  • Severe head injury was associated with lower TSH and free T3 levels.
  • Survival was linked to higher TSH and T3 levels, with TSH > 1 mU/l on day 1 observed only in survivors.

Conclusions:

  • Severe trauma induces a characteristic low T3/low T4 syndrome, irrespective of head injury.
  • Pituitary or hypothalamic dysfunction is likely, rather than primary hypothyroidism.
  • Thyroid function parameters, particularly TSH and T3, may serve as prognostic indicators in trauma patients.