Low T3 vs low T3T4 euthyroid sick syndrome in septic shock patients:A prospective observational cohort study

作     者：Mirza Kovacevic Visnja Nesek-Adam Semir Klokic Ekrema Mujaric 

作者机构：Department of AnesthesiologyResuscitation and Intensive CareCantonal HospitalZenica 72000Bosnia and Herzegovina Department of AnesthesiologyResuscitation and Intensive CareClinical Hospital Sveti DuhZagreb 10000Croatia GruppenpraxisGeneral Practitioner's OfficeLaufen 4242Switzerland Department of Internal DiseasesCantonal HospitalZenica 72000Bosnia and Herzegovina 

出 版 物：《World Journal of Critical Care Medicine》 (世界重症医学杂志)

年 卷 期：2024年第13卷第3期

页      面：53-62页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：approved by the Institutional Review Board(IRB)of Cantonal Hospital Zenica and the protocols used in the study were approved by the Ethical Committee of Cantonal Hospital Zenica(00-03-35-38-14/22) 

主　　题：Septic shock Euthyroid sick syndrome Low T3 Low T3T4 Intensive care unit 

摘      要：BACKGROUND Both phases of euthyroid sick syndrome(ESS)are associated with worse prognosis in septic shock *** there are still no indications for supplementation therapy,there is no evidence that both phases(initial and prolonged)are adaptive or that only prolonged is maladaptive and requires *** To analyze clinical,hemodynamic and laboratory differences in two groups of septic shock patients with *** A total of 47 septic shock patients with ESS were divided according to values of their thyroid hormones into low T3 and low T3T4 *** analysis included demographic data,mortality scores,intensive care unit stay,mechanical ventilation length and 28-day survival and laboratory with *** The Simplified Acute Physiology Score II score(P=0.029),dobutamine(P=0.003)and epinephrine requirement(P=0.000)and the incidence of renal failure and multiple organ failure(MOF)(P=0.000)were significantly higher for the low ***(P=0.047),neutrophilia(P=0.038),lymphopenia(P=0.013)and lactatemia(P=0.013)were more pronounced on T2 for the low T3T4 group compared to the low T3 *** blood pressure at T0(P=0.017)and T1(P=0.007),as well as mean arterial pressure at T0(P=0.037)and T2(P=0.033)was higher for the low T3 *** The low T3T4 population is associated with higher frequency of renal insufficiency and MOF,with worse laboratory and hemodynamic *** findings suggest potentially maladaptive changes in the chronic phase of septic shock.