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How to Administer Near-Infrared Spectroscopy in Critically ill Neonates, Infants, and Children
Published on: August 19, 2020
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Nonthyroidal illness in critically ill children
An Jacobs1, Ilse Vanhorebeek, Greet Van den Berghe
1Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven University Hospital, Leuven, Belgium.
Current Opinion in Endocrinology, Diabetes, and Obesity
|July 26, 2019
Summary
Nonthyroidal illness syndrome (NTI) in critically ill children may involve adaptive peripheral changes and maladaptive central changes. Metabolic interventions suggest targeting the central component could improve outcomes.
Area of Science:
- Pediatric Endocrinology
- Critical Care Medicine
- Thyroid Hormone Physiology
Background:
- Nonthyroidal illness syndrome (NTI) is common in critically ill children.
- NTI is characterized by altered thyroid hormone levels and is associated with poor outcomes.
Purpose of the Study:
- To review recent literature on NTI in pediatric critical illness.
- To provide insights into NTI pathophysiology and therapeutic strategies.
Main Methods:
- Literature review of studies on NTI in pediatric critical illness.
- Analysis of recent metabolic interventions and their impact on NTI.
Main Results:
- NTI severity correlates with poor pediatric critical illness outcomes.
- Metabolic interventions improved outcomes and altered NTI components.
- Peripheral NTI component (hormone inactivation) may be adaptive; central component (suppressed TSH) may be maladaptive.
Conclusions:
- NTI in critically ill children can be modulated by metabolic interventions.
- Peripheral NTI may be a beneficial adaptation, while central NTI might be detrimental.
- Further research, including RCTs, is needed to explore therapeutic reactivation of the central NTI component.
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