6 The clinical significance of various changes in the thyroid hormone levels and the appropriateness of endocrine intervention is controversial. These include abnormalities in the levels of thyroid, 1 - 3 adrenocortical, 4 growth, 5 and sex hormones. Multiple endocrine derangements have been described in critically ill patients.

Mortality for the total group was 15 (22.7%) of 66 patients.Ĭonclusion There is a 12% incidence of simultaneous hypothyroidism and adrenal insufficiency in our study and the routine testing for both may be indicated in this population of critically ill patients. All patients with endocrine abnormalities were treated. Eight patients (12.1%) had both hypothyroidism and adrenal insufficiency. Five patients (7.6%) had hypothyroidism alone and 35 (53.0%) had only adrenal insufficiency. Twenty-seven patients (40.9%) had severe sepsis, 31 (46.9%) had septic shock, and 8 (12.1%) had hemorrhagic shock. The mean (SD) Acute Physiology and Chronic Health Evaluation II score was 21 (5). Main Outcome Measures Incidence of hypothyroidism and adrenal insufficiency and mortality. A second measurement of the cortisol level was performed 1 hour later. Interventions Thyrotropin and baseline cortisol levels were obtained at 3 AM followed by intravenous injection of 250 μg of cosyntropin, a synthetic adrenocorticotropic hormone derivative. Patients Sixty-six consecutive patients with severe sepsis, septic shock, and hemorrhagic shock who required pulmonary artery catheterization for resuscitation were studied. Setting Surgical intensive care unit of a university-affiliated tertiary referral center. Hypothesis We hypothesized that hypothyroidism and adrenal insufficiency frequently occur together in critically ill patients.ĭesign A prospective observational study. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.

Hyperthyroidism and adrenaline