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 Serum potassium levels and outcomes in critically ill patients in the medical intensive care unit

2018 ◽  
Vol 46 (3) ◽  
pp. 1254-1262 ◽  
Author(s):  
Surat Tongyoo ◽  
Tanuwong Viarasilpa ◽  
Chairat Permpikul
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Serum Potassium ◽  
Critically Ill Patients ◽  
Medical Intensive Care Unit ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Icu Mortality ◽  
Medical Intensive Care

Objective To compare the outcomes of patients with and without a mean serum potassium (K+) level within the recommended range (3.5–4.5 mEq/L). Methods This prospective cohort study involved patients admitted to the medical intensive care unit (ICU) of Siriraj Hospital from May 2012 to February 2013. The patients’ baseline characteristics, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, serum K+ level, and hospital outcomes were recorded. Patients with a mean K+ level of 3.5 to 4.5 mEq/L and with all individual K+ values of 3.0 to 5.0 mEq/L were allocated to the normal K+ group. The remaining patients were allocated to the abnormal K+ group. Results In total, 160 patients were included. Their mean age was 59.3±18.3 years, and their mean APACHE II score was 21.8±14.0. The normal K+ group comprised 74 (46.3%) patients. The abnormal K+ group had a significantly higher mean APACHE II score, proportion of coronary artery disease, and rate of vasopressor treatment. An abnormal serum K+ level was associated with significantly higher ICU mortality and incidence of ventricular fibrillation. Conclusion Critically ill patients with abnormal K+ levels had a higher incidence of ventricular arrhythmia and ICU mortality than patients with normal K+ levels.

Outcomes of Critically Ill Gynecological Cancer Patients Admitted to Intensive Care Unit

2012 ◽  
Vol 30 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Silvio A. Ñamendys-Silva ◽  
María O. González-Herrera ◽  
Julia Texcocano-Becerra ◽  
Angel Herrera-Gómez
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Gynecological Cancer ◽  
Apache Ii ◽  
Apache Ii Score

Purpose: To assess the characteristics of critically ill patients with gynecological cancer, and to evaluate their prognosis. Methods: Fifty-two critically ill patients with gynecological cancer admitted to intensive care unit (ICU) were included. Univariate and multivariate logistic regressions were used to identify factors associated with hospital mortality. Results: Thirty-five patients (67.3%) had carcinoma of the cervix uteri and 11 (21.2%) had ovarian cancer. The mortality rate in the ICU was 17.3% (9 of 52) and hospital mortality rate were 23%(12 of 52). In the multivariate analysis, independent prognostic factors for hospital mortality were vasopressor use (odds ratio [OR] = 8.60, 95% confidence interval [CI] 2.05-36; P = .03) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 1.43, 95% CI 1.01-2.09; P = .048). Conclusions: The independent prognostic factors for hospital mortality were the need for vasopressors and the APACHE II score.

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.

APACHE II score for critically ill patients with a solid tumor: A reclassification study

2018 ◽  
Vol 65 (8) ◽  
pp. 447-455 ◽  
Author(s):  
F.D. Martos-Benítez ◽  
I. Cordero-Escobar ◽  
A. Soto-García ◽  
I. Betancourt-Plaza ◽  
I. González-Martínez
Keyword(s):  
Critically Ill ◽  
Solid Tumor ◽  
Critically Ill Patients ◽  
Apache Ii ◽  
Apache Ii Score

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 Effects of Substitution and High-Dose Thyroid Hormone Therapy on Deiodination, Sulfoconjugation, and Tissue Thyroid Hormone Levels in Prolonged Critically Ill Rabbits

Endocrinology ◽  
2008 ◽  
Vol 149 (8) ◽  
pp. 4218-4228 ◽  
Author(s):  
Yves Debaveye ◽  
Björn Ellger ◽  
Liese Mebis ◽  
Theo J. Visser ◽  
Veerle M. Darras ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Hormone Therapy ◽  
Critically Ill ◽  
Kidney Tissue ◽  
High Dose ◽  
Reverse T3 ◽  
Hormone Levels ◽  
Liver And Kidney ◽  
Thyroid Hormone Levels ◽  
The Impact

To delineate the metabolic fate of thyroid hormone in prolonged critically ill rabbits, we investigated the impact of two dose regimes of thyroid hormone on plasma 3,3′-diiodothyronine (T2) and T4S, deiodinase type 1 (D1) and D3 activity, and tissue iodothyronine levels in liver and kidney, as compared with saline and TRH. D2-expressing tissues were ignored. The regimens comprised either substitution dose or a 3- to 5- fold higher dose of T4 and T3, either alone or combined, targeted to achieve plasma thyroid hormone levels obtained by TRH. Compared with healthy animals, saline-treated ill rabbits revealed lower plasma T3 (P = 0.006), hepatic T3 (P = 0.02), and hepatic D1 activity (P = 0.01). Substitution-dosed thyroid hormone therapy did not affect these changes except a further decline in plasma (P = 0.0006) and tissue T4 (P = 0.04). High-dosed thyroid hormone therapy elevated plasma and tissue iodothyronine levels and hepatic D1 activity, as did TRH. Changes in iodothyronine tissue levels mimicked changes in plasma. Tissue T3 and tissue T3/reverse T3 ratio correlated with deiodinase activities. Neither substitution- nor high-dose treatment altered plasma T2. Plasma T4S was increased only by T4 in high dose. We conclude that in prolonged critically ill rabbits, low plasma T3 levels were associated with low liver and kidney T3 levels. Restoration of plasma and liver and kidney tissue iodothyronine levels was not achieved by thyroid hormone in substitution dose but instead required severalfold this dose. This indicates thyroid hormone hypermetabolism, which in this model of critical illness is not entirely explained by deiodination or by sulfoconjugation.

scholarly journals Prolonged muscle inactivity and evaluation of peripheral neuromuscular features in patients hospitalized in Intensive Care Units

2019 ◽  
Vol 12 (2) ◽  
pp. 50-64
Author(s):  
George Elesnitsalis ◽  
Ioannis Amiridis ◽  
Dimitrios Patikas ◽  
Ioanna Vekili ◽  
Maria Vourvou
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Conduction Velocity ◽  
Soleus Muscle ◽  
Critically Ill Patients ◽  
Tibial Nerve ◽  
H Reflex ◽  
Apache Ii Score ◽  
M Wave ◽  
Stimulation Of

Introduction: Polyneuromyopathy constitutes a common complication in critically ill patients of the Intensive Care Unit (ICU) and in the last few years it appears to be identified as a syndrome detectable in the limbs and respiratory muscles. It is associated with the difficulties during weaning from mechanical ventilation. Aim: The present study investigates the reflective reaction of the soleus muscle following an electrical stimulation of the tibial nerve in intubated critically ill patients hospitalized in ICU with no medical history prior to their admission. Methods: Thirteen (13) patients who had been hospitalized for more than five (5) days and had a high APACHE II score (>15) and 13 age-matched control subjects were asked to participate in the present study on a volunteer basis. During the study, as reflective response parameters the range of the H-reflex and M-wave of the soleus muscle, as well as the conduction velocity of the tibial nerve, after electro-stimulation of the tibial nerve at the popliteal-fossa level, were assessed Results: Statistical analysis revealed significantly lower values in the ICU patients compared to healthy controls in both H-reflex range (p<0,049) and the M-wave range (p<0,041), as well as conduction velocity (p<0,001) of the tibial nerve. Conclusions: It is concluded that the reflective response of the soleus muscle as well as the tibial nerve’s conduction velocity are affected in critically ill patients hospitalized in ICU. The study of the above neurological parameters can provide further insights into the establishment and progress of polyneuromyopathy of critically ill patients in ICUs.

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