scholarly journals Evaluation of Thyroid Hormone Levels in Full-Term Neonates Presented with Septic Shock

2021 ◽  
Vol 8 (4) ◽  
pp. 168-174
Author(s):  
Dr. Dhananjay Singh ◽  
◽  
Dr. Jyotsana Shrivastava ◽  
Dr. Amit Agrawal ◽  
◽  
...  
Keyword(s):  
Septic Shock ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Mean Value ◽  
Full Term ◽  
Term Neonates ◽  
Hormone Levels ◽  
The Mean ◽  
Thyroid Hormone Levels ◽  
Thyroid Profile

Introduction: The incidence of neonatal sepsis in India is 38 per 1000 live births. Many authorsfound an association between altered thyroid hormone levels and septic shock in neonates and itmay be of prognostic importance in septic shock treatment. This study has been conducted to findthe relationship between thyroid profile and septic shock in neonates and also to compare thethyroid profile in survivor and non-survivor groups of septic shock patients. Methods: Thisanalytical prospective cohort study was conducted in the NICU of a tertiary care teaching institutionin central India. Full-term neonates with late-onset sepsis were included in this study and estimationof thyroid hormones (TSH, T3, T4, fT3, and fT4) was performed. These neonates were divided intothose with and without septic shock patients and levels of thyroid hormones were correlatedbetween these patients to find significant relations. The Vasoactive-Inotropic Score (VIS) score wascalculated. Results: A total of 195 full-term neonates were included in the study. The mean value ofTSH, T3, T4, fT3, and fT4 among neonates with septic shock were 5.27 μg/ml, 80.01 ng/dl, 6.36μg/dl, 1.40 pg/ml, and 1.40 μg/dl, respectively while the values were 5.29 μg/ml, 94.4 ng/dl, 7.25μg/dl, 1.84 pg/ml, and 1.43 μg/dl, respectively in septic neonates without shock. This difference wasstatistically significant except for TSH (p>0.05). The mean value of TSH, T3, T4, fT3, and fT4 amongseptic shock survivors were 5.27 μg/ml, 80.01 ng/dl, 6.36 μg/dl, 1.40 pg/ml, and 1.40 μg/dl and inseptic shock non-survivors were 2.40 μg/ml, 37.33 ng/dl, 3.86 μg/dl, 0.99 pg/ml, and 0.84 μg/dl,respectively (p<0.0001). Only T3 was found to be significantly co-related with VIS in septic shock inall the groups (<0.001). Conclusion: Our study suggests that TSH, T3, T4, fT3, and fT4 levels aresignificantly low in patients suffering from the septic shock which may vary in the case of TSH. Also,there is a significant decrease in thyroid profile among septic shock non-survivors as compared tosurvivors.

scholarly journals Correlation of Thyroid Hormones in the Prognosis of Critically Ill Patients

2021 ◽  
Vol 73 (3) ◽  
pp. 161-166
Author(s):  
Sneha R. Chavanda ◽  
Rajendra R. Mane
Keyword(s):  
Intensive Care ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Thyroid Profile

Objective: Non-thyroidal illness syndrome (NTIS) is associated with outcomes in Intensive Care Unit(ICU) patients. The objectives of the study were to assess the prognostic value of complete thyroid profile in critically ill patients and to determine the effect of thyroid hormone level in predicting mortality when used along with acute physiology and chronic health evaluation (APACHE) II score.Methods: The observational study was conducted at a tertiary care centre in Kolhapur, India. Critically ill adult patients admitted to intensive care units with APACHE II >10 was included(n=50). Relevant clinical investigations along with thyroid profile evaluation was carried out and APACHE II was calculated.  Baseline characteristics of patients were compared.  Performance of variables in predicting mortality was analysed. Correlation of APACHE II score with thyroid was also assessed in R software v-3.6.1.Results: The survival rate at ICU discharge was 54%. Mean T3, FT3, and T4 levels were significantly low in non-survivors(p=0.006758, p=0.0245 and p=0.00070 respectively).  Mean APACHE II score was significantly high in non- survivor(p=2.94E-06). APACHE II score was significantly associated with the severity of disease (p=0.0235). APACHE II scores and FT3 were better predictors of mortality compared to other thyroid hormones (AUC =0.8519±0.0535). FT3 showed high correlation with APACHE II score(r=-0.4083; p=0.0032). Inclusion of thyroid hormone levels with APACHE II scores improved the prediction of mortality in critically ill patients by 5.63%.Conclusion: Among thyroid hormones, FT3 is a better predictor of mortality. Use of thyroid hormone levels in conjunction with APACHE II scores improves the prognostication.

scholarly journals Thyroid hormones reference ranges during each trimester of normal pregnancy subjects in Andhra Pradesh, South India

2019 ◽  
Vol 7 (12) ◽  
pp. 4499
Author(s):  
V. Uma ◽  
A. V. Suresh Babu ◽  
Hanumanth N.
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Andhra Pradesh ◽  
Normal Pregnancy ◽  
Reference Intervals ◽  
Full Term ◽  
Specific Reference ◽  
Reference Ranges ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

Background: The Thyroid hormones normal levels are very much essential for fetal neural development and good pregnancy outcome. Thyroid insufficiency during pregnancy may be associated with adverse obstetric outcome and fetal neurodevelopmental deficits. The main objective of the study is to estimate and establish the reference ranges of thyroid hormones as it varies from place to place and inter dependent on the iodine levels as the American Thyroid Association strongly recommends to refer to population defined trimester-specific reference ranges.Methods: A longitudinal study was conducted at obstetric clinic, Kakinada city, Andhra Pradesh over a period of 18 months. The total number of normal pregnancy subjects included in this study was 126. Thyroid hormones estimation was done by Competitive electrochemiluminescence (T3 and T4) and Sandwich electrochemiluminescence (TSH) at Thyorocare Laboratory. Only 47 subjects were having all three trimester thyroid hormone levels estimated during each trimester and were followed up to full term. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester.Results: The thyroid hormone levels during first, second and third trimesters median with reference intervals - Total Triiodothyronine (T3) : 163(100.2-230), 168(121-219.2), 168(110.2-222.6) ng/dl ,Total Thyroxine (T4) : 8.4(4.05-16.64) , 10.2(4.09-18.7), 11.2(3.8-16.7) μg/dl and Thyroid Stimulating Hormone (TSH ):2.52(1.6-7.9) 3.01(1.28-7.6) 3(1.5-8.4) μIU/mlConclusions: The trimester-specific reference intervals and median for thyroid hormones during normal pregnancy have been established for pregnant South Indian women in Andhra Pradesh by full term follow-up during pregnancy using 2.5th and 97.5th percentiles and median.

Predictive value of thyroxine for prognosis in pediatric septic shock: a prospective observational study

2020 ◽  
Vol 33 (5) ◽  
pp. 653-659
Author(s):  
Jia Song ◽  
Yun Cui ◽  
Chunxia Wang ◽  
Jiaying Dou ◽  
Huijie Miao ◽  
...  
Keyword(s):  
Septic Shock ◽  
Thyroid Hormone ◽  
Observational Study ◽  
Hospital Mortality ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Threshold Value ◽  
Nonthyroidal Illness ◽  
Hormone Levels ◽  
Thyroid Hormone Levels

AbstractBackgroundThyroid hormone plays an important role in the adaptation of metabolic function to critically ill. The relationship between thyroid hormone levels and the outcomes of septic shock is still unclear. The aim of this study was to assess the predictive value of thyroid hormone for prognosis in pediatric septic shock.MethodsWe performed a prospective observational study in a pediatric intensive care unit (PICU). Patients with septic shock were enrolled from August 2017 to July 2019. Clinical and laboratory indexes were collected, and thyroid hormone levels were measured on PICU admission.ResultsNinety-three patients who fulfilled the inclusion criteria were enrolled in this study. The incidence of nonthyroidal illness syndrome (NTIS) was 87.09% (81/93) in patients with septic shock. Multivariate logistic regression analysis showed that T4 level was independently associated with in-hospital mortality in patients with septic shock (OR: 0.965, 95% CI: 0.937–0.993, p = 0.017). The area under receiver operating characteristic (ROC) curve (AUC) for T4 was 0.762 (95% CI: 0.655–0.869). The cutoff threshold value of 58.71 nmol/L for T4 offered a sensitivity of 61.54% and a specificity of 85.07%, and patients with T4 < 58.71 nmol/L showed high mortality (60.0%). Moreover, T4 levels were negatively associated with the pediatric risk of mortality III scores (PRISM III), lactate (Lac) level in septic shock children.ConclusionsNonthyroidal illness syndrome is common in pediatric septic shock. T4 is an independent predictor for in-hospital mortality, and patients with T4 < 58.71 nmol/L on PICU admission could be with a risk of hospital mortality.

The Effect of Long-Term Metabolic Control on Free Thyroid Hormone Levels in Diabetics during Insulin Treatment

1987 ◽  
Vol 24 (5) ◽  
pp. 466-469 ◽  
Author(s):  
J H Parr
Keyword(s):  
Thyroid Hormone ◽  
Metabolic Control ◽  
Insulin Treatment ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Hormone Levels ◽  
Free Thyroid Hormone ◽  
The Mean ◽  
Thyroid Hormone Levels

Serum concentration of free T3 and, in female patients, FT4, were found to be lower in 20 asymptomatic, moderately-poor or well controlled, diabetics treated with insulin than in a group of non-diabetic subjects. Over a mean 3-month period of the study a significant fall occurred in HbA1 concentration in both groups of diabetics without change in free thyroid hormone levels. The mean capillary blood glucose, fasting free insulin and fasting lipid concentrations, other than high density lipoprotein (HDL) cholesterol, did not change. No correlations were found between the changes in HbA1 and free thyroid hormone concentrations. Improvement in long term metabolic control did not influence free thyroid hormone levels in well controlled and moderately-poor controlled diabetics, taking insulin.

scholarly journals A Brief Exposure to Moderate Passive Smoke Increases Metabolism and Thyroid Hormone Secretion

2007 ◽  
Vol 92 (1) ◽  
pp. 208-211 ◽  
Author(s):  
Giorgos S. Metsios ◽  
Andreas D. Flouris ◽  
Athanasios Z. Jamurtas ◽  
Andres E. Carrillo ◽  
Demetrios Kouretas ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Passive Smoking ◽  
Repeated Measures ◽  
Hormone Secretion ◽  
Free T4 ◽  
Hormone Levels ◽  
Urine Cotinine ◽  
The Mean ◽  
Thyroid Hormone Levels ◽  
Serum And Urine

Abstract Context: Active smoking influences normal metabolic status and thyroid function. Objective: The objective was to assess experimentally the effects of 1 h of moderate passive smoking in a controlled simulated bar/restaurant environment on the metabolism and thyroid hormone levels in healthy nonsmokers. Participants: Eighteen (nine females, nine males) healthy individuals (mean ± sd: age, 25.3 ± 3.1 yr; height, 174.0 ± 10.1 cm; weight, 65.2 ± 13.7 kg) participated in the study. Design: In repeated-measures randomized blocks, participants visited the laboratory on 2 consecutive days. In the experimental condition, they were exposed to 1 h of moderate passive smoking at a carbon monoxide concentration of 23 ± 1 ppm in an environmental chamber, whereas in the control condition participants remained in the same chamber for 1 h breathing normal atmospheric air. Main Outcome Measures: In both conditions, cotinine serum and urine levels, resting energy expenditure (REE), as well as concentration of T3, free T4, and TSH were assessed before participants entered the chamber and immediately after their exit. Heart rate and blood pressure were tested in 10-min intervals during all REE assessments. Results: The mean ± sd difference of serum and urine cotinine levels (−0.27 ± 3.94 vs. 14.01 ± 6.54 and 0.05 ± 2.07 vs. 7.23 ± 3.75, respectively), REE (6.73 ± 98.06 vs. 80.58 ± 120.91) as well as T3 and free T4 (0.05 ± 0.11 vs. 0.13 ± 0.12 and 0.02 ± 0.15 vs. 0.22 ± 0.20) were increased in the experimental compared with the control condition at baseline and follow-up (P &lt; 0.05). No statistically significant variation was observed in the mean difference of the remaining parameters (P &gt; 0.05). Serum and urine cotinine values were linearly associated with REE (P &lt; 0.05). Conclusion: One hour of passive smoking at bar/restaurant levels is accompanied by significant increases in metabolism and thyroid hormone levels.

scholarly journals Study of Thyroid Hormone Status in Normal Newborn and Preterm, Low Birth Weight Baby

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 787-790
Author(s):  
Tanvir Iqbal ◽  
M Obaidulla Ibne Ali ◽  
Nur E Atia ◽  
Tahorul Islam
Keyword(s):  
Birth Weight ◽  
Thyroid Hormone ◽  
Thyroid Gland ◽  
Low Birth Weight ◽  
Newborn Baby ◽  
Preterm Neonates ◽  
Hormone Levels ◽  
Low Birth Weight Babies ◽  
The Mean ◽  
Thyroid Hormone Levels

Background: Screening for thyroid hormones in the newborn baby is extremely important to detect the newborns who are borned with hypofunctional state of thyroid gland. This screening program in first few weeks of life is essential to prevent serious complications of hypothyroidism in future such as mental retardation.Objective: To assess the thyroid hormone levels in normal newborn and preterm, low birth weight babies and comparison of thyroid dysfunction between these two groups.Method: This cross - sectional analytical type of study was conducted in the department of physiology and paediatrics of Rajshahi Medical College & Hospital (RMCH) from July 2015 to June 2016. A total of 70 newborn baby were enrolled by systematic sampling of which 40 were normal healthy newborn and 30 were preterm, low birth weight babies. Data was collected from the parents and they were filled out standard questionnaire. Then venous blood was collected from each and every neonate and blood was sent to laboratory for estimation of thyroid hormone levels. FT4 and TSH values were estimated as these two are the most important parameters for determination of thyroid function.Result: In this study, the mean (±SD) serum FT4 level in term and preterm neonates were 14.17±2.14 and 12.25±3.16 (pg/ml) respectively. This FT4 value is significantly higher in term neonates than preterm neonates (P<0.05). The mean (±SD) serum TSH level in term and preterm neonates were 3.37±2.12 and 4.23±3.23 (?IU/ml) respectively. Statistically there was no significant difference in TSH values between these two groups (P 0.05).Conclusion: From this study it was evident that preterm, low birth weight babies are more likely to develop hypofunctional state of thyroid gland than normal term babies. The newborns who were found hypothyroid, were informed to their parents for consultation with the concerned physicians. The physicians then took necessary steps to correct the hypofunctional state of thyroid gland.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 787-790

Hypothyroidism does not affect the dihydropyridine sensitivity of precontracted murine uterus

2003 ◽  
Vol 81 (9) ◽  
pp. 890-893 ◽  
Author(s):  
Jörg W Wegener ◽  
Matthias Lee ◽  
Franz Hofmann
Keyword(s):  
Smooth Muscle ◽  
Cell Differentiation ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Rat Uterus ◽  
Hormone Levels ◽  
Uterine Muscle ◽  
Channel Expression ◽  
Thyroid Hormone Levels ◽  
Pregnant State

Thyroid hormones are known to influence various processes of cell differentiation. Recently, it was reported that hypothyroidism reduces the sensitivity to Ca2+-channel antagonists in the rat uterus. We examined the sensitivity to dihydropyridines of the uterus from mice that had reduced thyroid hormone levels. Isradipine relaxed with the same potency precontracted uterine muscle strips from control and hypothyroid mice, independently from a pseudo-pregnant state. These results demonstrate that hypothyroidism does not change dihydropyridine sensitivity (i.e., the pattern of Ca2+-channel expression) in the murine uterus.Key words: uterus, smooth muscle, Ca2+ channel, isradipine.

scholarly journals SAT-LB80 Elevated Pre-Op Thyrotropin Levels Are Associated With Increased 30-Day Mortality in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Shariq Rashid Masoodi ◽  
Rameesa Batul ◽  
Khurram Maqbool ◽  
Amir Zahoor ◽  
Mona Sood ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Hormone Levels ◽  
Icu Stay ◽  
Thyroid Hormone Levels ◽  
Serum Thyroid Hormones

Abstract BACKGROUND: The association between thyroid dysfunction and postoperative mortality is contentious. Thyroid function is frequently depressed during and after cardiopulmonary bypass surgical procedures, and this may adversely affect myocardial performance and postop outcome.OBJECTIVES: To study i) the changes and clinical significance of serum thyroid hormones during cardiopulmonary bypass (CPB), and ii) the association between biochemically assessed peri-op thyroid function and 30-day mortality after CBPSTUDY DESIGN: Prospective Cohort StudySUBJECTS: 279 patients undergoing various cardiac surgeries under cardiopulmonary bypass.METHODS: All consenting patients undergoing open heart surgery in last five years at a tertiary care centre in North-India were studied. The thyroid hormone levels (Total T3, T4 and TSH) were measured before admission, and postoperatively on Day 1 & 7, and 3 months following surgery. The patients’ gender, age, weight, body mass index, heart disease details, previous cardiac surgeries, and cardiac surgery-related data such as pump time, aortic clamping time, hypothermia duration, postoperative hemodynamic status and postoperative use of inotropic drugs were recorded and analysed. Patients were classified as having biochemically overt or subclinical hyperthyroidism or hypothyroidism, normal thyroid function, or non-classifiable state based on preoperative thyroid-stimulating hormone and total T4 values. Outcome data were collected from hospital records. Biochemical thyroid dysfunction was not systematically treated. Outcomes measured were length of ICU stay, postoperative complications and 30-day mortality.RESULTS: There was significant changes in thyroid function in patients undergoing cardiopulmonary bypass surgery (Fig 1). All patients showed a decrease in T3, T4 and TSH after surgery. Post-op complications were observed in 137 patients (49%) most common being atrial fibrillation (34%) followed by acute kidney injury (23%), infections (18%), dyselectrolytemia (7%), bleeding (1.4%) and ARDS (1.4%). Of 263 patients followed, eventually 26 patients expired with a mortality rate of 8.89% (95% CI, 0.4 - 19.4). Perioperatively, there was a significant correlation between 30-day with type of surgery (r, 0.26), aortic clamp time (r, 0.45), CBP time (r, 0.48), number of inotropes used (r, 0.57), hours of mechanical ventilation (r, 0.4), ICU stay (r, 0.13) and post-op complications (r, 0.24), as well as with the reduction in the thyroid hormone levels; 17 (7%), 3 (20%) and 6 (46%) patients of those with pre-op TSH level of &lt;6.5, &gt;6.5 and &gt;10.5 mIU/L expired (p &lt;0.001).CONCLUSION: Pre-op thyroid dysfunction is associated with increased mortality in patients undergoing cardiac surgery with CBP. Excess mortality with elevated serum TSH levels suggests the importance of timely detection and intervention in individuals with thyroid dysfunction undergoing cardiac surgery.Table of Contents oTable 1. Characteristics of patients who expired versus those who survived cardiac surgery with cardiopulmonary bypass (CPB) oFig 1. Changes in serum thyroid hormones during CPB surgery oTable 1. Characteristics of patients who expired versus those who survived cardiac surgery with cardiopulmonary bypass (CPB) oFigures in parenthesis indicate ±Standard Deviation, unless indicated otherwise oFig 1. Changes in serum thyroid hormones during CPB surgery

Developmentally regulated thyroid hormone distributor proteins in marsupials, a reptile, and fish

2005 ◽  
Vol 288 (5) ◽  
pp. R1264-R1272 ◽  
Author(s):  
Samantha J. Richardson ◽  
Julie A. Monk ◽  
Caroline A. Shepherdley ◽  
Lars O. E. Ebbesson ◽  
Frank Sin ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Sea Bream ◽  
Aqueous Environment ◽  
Critical Periods ◽  
Developmentally Regulated ◽  
Thyroxine Binding Globulin ◽  
Hormone Levels ◽  
Thyroid Hormone Levels ◽  
Lipid Environment

Thyroid hormones are essential for vertebrate development. There is a characteristic rise in thyroid hormone levels in blood during critical periods of thyroid hormone-regulated development. Thyroid hormones are lipophilic compounds, which readily partition from an aqueous environment into a lipid environment. Thyroid hormone distributor proteins are required to ensure adequate distribution of thyroid hormones, throughout the aqueous environment of the blood, and to counteract the avid partitioning of thyroid hormones into the lipid environment of cell membranes. In human blood, these proteins are albumin, transthyretin and thyroxine-binding globulin. We analyzed the developmental profile of thyroid hormone distributor proteins in serum from a representative of each order of marsupials ( M. eugenii; S.crassicaudata), a reptile ( C. porosus), in two species of salmonoid fishes ( S. salar; O. tshawytsch), and throughout a calendar year for sea bream ( S. aurata). We demonstrated that during development, these animals have a thyroid hormone distributor protein present in their blood which is not present in the adult blood. At least in mammals, this additional protein has higher affinity for thyroid hormones than the thyroid hormone distributor proteins in the blood of the adult. In fish, reptile and polyprotodont marsupial, this protein was transthyretin. In a diprotodont marsupial, it was thyroxine-binding globulin. We propose an hypothesis that an augmented thyroid hormone distributor protein network contributes to the rise in total thyroid hormone levels in the blood during development.

Sign in / Sign up

Export Citation Format

Share Document