Analysis of Thyroid Function Test Results in Critically ill Patient

This becomes a challenge to the laboratory consultants to validate TFT results of critically ill patients as their results are abnormally altered. These alterations in a euthyroid, systematically ill patients are referred to as "Euthyroid sick syndrome". There are selected patients in ICU...

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Bibliographic Details
Published in:Indian journal of clinical biochemistry 2014-12, Vol.29 (S1), p.S134
Main Authors: Chattopadhyay, Somasri, Patra, Saurav, Das, Ashok Kumar, Das, Biswanath
Format: Article
Language:English
Subjects:
Analysis
Hypothyroidism
Thyroid gland
Thyroid hormones
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Summary:This becomes a challenge to the laboratory consultants to validate TFT results of critically ill patients as their results are abnormally altered. These alterations in a euthyroid, systematically ill patients are referred to as "Euthyroid sick syndrome". There are selected patients in ICU who actually have biochemically perturbed thyroid function, either hypothyroidism or hyperthyroidism. The aim was to analyse TFT results of critically-ill patients, their clinical status & past history of any thyroid disease & find out the pattern of TFT in true thyroidal disorders. TFT of patients admitted in ICU & MICU of KIMS were analysed in the Central Laboratory, done in the backdrop of clinical assessment of thyroid status on admission & in the past. The data was analysed & various trends were analysed using correlation coefficient analysis & student's 't' test. Most patients had normal TSH level but altered [TT.sub.3] & [TT.sub.4]. Majority had low [TT.sub.3] & [TT.sub.4] levels (mean 4.0) with normal TSH. [FT.sub.3] was increased and [FT.sub.4] normal with normal TSH in one group. Few had lowered [FT.sub.3] & normal [FT.sub.4] with normal TSH. From the results analysed it was concluded that if past history of thyroid disease is ruled out then most TFT results should be repeated in patients once they are out of the acute condition to assess their true thyroidal status. Thyroid function generally returns to normal as the acutce illness resolves. A consensus should be created among the physicians whether to perform [TT.sub.3] & [TT.sub.4] or perform [FT.sub.3] & [FT.sub.4] along with TSH levels.
ISSN:0970-1915