Thyroid Hormone Profile in Children with Sepsis: Does Euthyroid Sick Syndrome Exist?

Yanni, Gema Nazri; Destariani, Cynthea Prima; Lubis, Arlina Nurbaity; Deliana, Melda

doi:10.3889/oamjms.2019.262

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…Pikala Tarakeswara Rao et al ( 2019) 14 observed that Serum T3, T4, Free T3 and Free T4 levels were significantly lower among cases of neonatal sepsis as compared to gestational age matched control. Yanni G N et al (2019) 15 observed that Level of T3 and T4 were decreased on day 1 in pediatric sepsis. Of 80 subjects, 57 (71.2%) with low level T3 and 41 (51.2%) with low T4 were found.…”

Section: Discussionmentioning

confidence: 98%

Thyroid Abnormalities in Children with Sepsis

Kumari

Meena

Gurjar

2023

Int J Sci Healthcare Res

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Introduction: Sepsis is the most common cause of mortality in infants and children. A hormonal disorder that often affected in sepsis is thyroid hormones which occur in the form of euthyroid sick syndrome (ESS) or nonthyroidal illness syndrome (NTIS). The aim of study was to evaluate thyroid hormones changes and the outcome in children with sepsis. Materials and Methods: Present study is hospital based observational cohort study.70 children with diagnosed sepsis were required in sample size. Serum free T3, free T4 and TSH was measured on day one and also on follow up (7th day). Result: on day one Serum FT3 level was low in 40 (57.2%) subjects and Serum FT4 level was low in 12 (17.2%) subjects. TSH was normal in most 66 (94.2%) of subjects. Mortality was more in children with low serum FT3 (22.5%) as compared to those with normal FT3 (3.4%). Mortality was also more in children with low serum FT4 level (41.6%) as compared to those with normal FT4 level (8.7%), (p=0.002). Mortality was more in children with low serum FT3 (29%) on follow up as compared to those with normal FT3 (2.5%) (p=0.001). Conclusion: Thyroid hormones dysfunctions are common in children with sepsis. Mortality is significantly associated with low levels of serum FT3 & FT4. So Thyroid hormones dysfunctions could be an indicator of disease severity with possible need for hormone supplementation. Keywords: Thyroid hormones, Serum free T3, free T4, TSH, sepsis, children

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Section: Discussionmentioning

confidence: 98%

Thyroid Abnormalities in Children with Sepsis

Kumari

Meena

Gurjar

2023

Int J Sci Healthcare Res

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“…That alteration is predominantly brought about by altered peripheral conversion of T4. Two researches before concluded that levels of FT3 and FT4 were lower in sepsis patients and animal models respectively [ 12 , 13 ]. The theories explaining the role of this phenomenon include the compensatory role in relation to the oxidative stress associated with acute disease [ 14 ], and the adaptive role—as an attempt to reduce energy consumption and protect against protein catabolism [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Decreased circulating levels of free triiodothyronine in Sepsis children and correlation analysis

Long

Liu

et al. 2022

BMC Pediatr

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Background Intensive physical stress in sepsis can induce the disorder of endocrine function and impact the clinical course and prognosis. Low T3 syndrome has been verified to be the predictive indicator of poor prognosis in several researches. Reports on the influence factors of thyroid hormonal levels in children with severe sepsis are rare. We aim to investigate the thyroid hormonal variations in the course of sepsis and analyze that how to be affected by clinical data and inflammatory biomarkers. Methods In the case-control study, 184 children with sepsis and 323 controls were included in Tongji Hospital, Wuhan, China, in 2019. Data on clinical and inflammatory parameters were collected from all participants. Circulating FT3(Free Triiodothyronine) levels were measured by Electrochemiluminescence immunoassay. Finally, we investigated the correlation between FT3 and related variables with linear regression analysis. Results Serum FT3 was lower in the sepsis group than in control group(2.59 + 1.17 vs 2.83 + 1.01 pg/mL, p < 0.05). Significant moderately negative correlations(|r| > 0.3) of FT3 levels with ferritin, PCT, duration of symptoms, SOFA score, and mortality were revealed. Moreover, we observed that FT3 had the positive correlation with albumin, as well as white blood cell count. Conclusions Concentrations of serum FT3 are dramatically declined in sepsis children than in control children. Our results demonstrate that recognizing the potential abnormality of thyroid hormones in sepsis patients and examine timely through abnormal common clinical data and inflammatory biomarkers is a fine option.

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“…14 Our findings are consistent with previous studies that found thyroid function abnormalities (most commonly fT3) in adult patients who were hospitalized for respiratory failure requiring invasive mechanical ventilation, yet inconsistent with the prognostic role of fT3 as a risk factor for higher mortality risk in adult patients with low fT3. [15][16][17][18][19] Prior work has also concluded that NTIS occurs in 70 to 93% of critically ill patients as noted by a reduction in serum T3 values 14,20 as demonstrated by Yanni, et al 21 who also reported low T3 and T4 levels on the first and third days of ICU admission. Moreover, our results are also similar to those reported by Galusova, et al 22 for fT3 and TSH levels in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Correlation of Nonthyroidal Illness Syndrome with Extubation Outcome in Mechanically Ventilated Children: A Prospective Cohort Study

Abdelaziz

Romih

Ismail

et al. 2022

J Pediatr Intensive Care

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This study aimed to assess the relationship between non-thyroidal illness syndrome (NTIS) and extubation outcomes in pediatric patients requiring mechanical ventilation. This prospective cohort study included 59 patients who underwent mechanical ventilation in the pediatric intensive care unit of a tertiary care university hospital from July 2020 to June 2021. Each patient underwent laboratory testing including serum levels of thyroid-stimulating hormone (TSH), free T3 (fT3), free T4 (fT4), and reverse T3 (rT3) on the first and third days of mechanical ventilation. On the first day of mechanical ventilation, 62.7% of patients had low fT3, which significantly increased to 78% of patients on the third day. In comparison to values on day one, median levels of fT3 and fT4 significantly decreased and rT3 significantly increased on day three. However, no significant differences were found in the median TSH levels over the same time span. Thirty-five patients (59%) survived while 24 patients (41%) did not survive. Compared with survivors, non-survivors had significantly higher median serum TSH levels on day one, while all other thyroid function tests assays did not significantly differ between days one and three. Of note, serum TSH, fT3, fT4, and rT3 levels, on the first and third days, did not differ significantly between patients who experienced extubation failure and extubation success. To the best of our knowledge, this is the first study to examine thyroid function values in mechanically ventilated children to determine their correlation with extubation outcomes. In this study, NTIS did not correlate with extubation outcomes in critically ill children undergoing mechanical ventilation.

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Thyroid Hormone Profile in Children with Sepsis: Does Euthyroid Sick Syndrome Exist?

Cited by 12 publications

References 21 publications

Thyroid Abnormalities in Children with Sepsis

Thyroid Abnormalities in Children with Sepsis

Decreased circulating levels of free triiodothyronine in Sepsis children and correlation analysis

Correlation of Nonthyroidal Illness Syndrome with Extubation Outcome in Mechanically Ventilated Children: A Prospective Cohort Study

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