Thyroid hormone alterations in trauma patients requiring massive transfusion: An observational study
10.5847/wjem.j.issn.1920-8642.2014.04.005
- Author:
Hifumi TORU
1
;
Okada ICHIRO
;
Kiriu NOBUAKI
;
Hasegawa EIJU
;
Ogasawara TOMOKO
;
Kato HIROSHI
;
Koido YUICHI
;
Inoue JUNICHI
;
Abe YUKO
;
Kawakita KENYA
;
Hagiike MASANOBU
;
Kuroda YASUHIRO
Author Information
1. Emergency Medical Center
- Publication Type:Journal Article
- Keywords:
Non-thyroidal illness syndrome;
Massive transfusion;
Trauma;
Free triiodothyronine;
Thyroid hormone
- From:
World Journal of Emergency Medicine
2014;5(4):270-274
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: Although non-thyroidal illness syndrome (NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine (fT3) levels in trauma patients requiring massive transfusion have not been reported. METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions (>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of fT3, free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation. RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial fT3 levels in group M (1.95±0.37 pg/mL) were significantly lower than those in group C (2.49±0.72 pg/mL;P<0.01) and remained low until 1 week after admission. Initial inter-group fT4 and TSH levels were not significantly different. TSH levels at 1 week (1.99±1.64 μIU/mL) were higher than at admission (1.48±0.5 μIU/mL) in group C (P<0.05). CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.
