[Characteristics of changes in the thyroid status in severe trauma and massive hemorrhage]

Dynamic measurements of the blood serum concentrations of thyrotropic hormone (TTH), prolactin, total and free triiodothyronine (T3), and thyroxin (T4) were carried out in 56 patients with grave combined mechanical injuries in the early posttraumatic period. Reduced T3 levels, variable changes in T4 content, and a relative increase of TTH and prolactin levels were observed in all the patients. Patients dying on days 1-5 after the trauma were characterized by the development of the "low T3 content" syndrome, reduced concentration of free T4, and the most expressed hyperprolactinemia. A direct correlation was established between reduction of the levels of total and free T4 and life duration. A hypothesis is proposed that incomplete reaction in the hypothalamus-pituitary-thyroid system and the absence of an adequate response of the thyroid to increased secretion of thyrotropin releasing factor and TTH is not only associated with, but determines early death.