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Pituitary-thyroid function in patients with septic shock and its relation with outcome
M Leon-Sanz1, J A Lorente, L Larrodera
1Hospital Universitario 12 de Octubre, Madrid, Spain.
European Journal of Medical Research
|February 28, 1998
Summary
Thyroid function abnormalities are common in septic shock. Survivors show improved thyroid hormone levels and a better response to TRH, indicating a less disturbed hypothalamic-pituitary-thyroid axis compared to non-survivors.
Area of Science:
- Endocrinology
- Critical Care Medicine
- Internal Medicine
Background:
- Septic shock is associated with significant physiological derangements.
- Thyroid dysfunction is frequently observed in critically ill patients.
Purpose of the Study:
- To investigate the temporal changes in thyroid function in septic shock patients.
- To correlate thyroid function abnormalities with patient outcomes.
Main Methods:
- Prospective study of 27 septic shock patients in a university hospital ICU.
- Measured total T4, total T3, TSH, and TSH response to TRH on days 1, 2, 5, and 6.
- Compared data between survivors and non-survivors.
Main Results:
- All patients had low thyroid hormones on day 1; survivors showed increased T3 and T4 by day 5.
- Survivors had higher basal TSH and TSH response to TRH on day 2.
- Nocturnal TSH surge was absent on day 1 in all patients, but recovered in survivors by day 5.
Conclusions:
- Septic shock alters the hypothalamic-pituitary-thyroid axis.
- Thyroid function recovery differentiates survivors from non-survivors.
- Survivors exhibit a more robust hypothalamic-pituitary-thyroid axis function and improvement over time.