The serum thyroid hormone profile in mechanically ventilated children: Does euthyroid sick syndrome exist?

Abstract

Background: The term "euthyroid sick syndrome" refers to alterations in thyroid function testing during critical illness. Mechanically ventilated children's thyroid hormone levels may be altered, although the reason for this remains a mystery.
Objective: This study was aimed to evaluate thyroid hormone profile in mechanically ventilated children and their correlation with mortality.
Patients and Methods: Thirty-four mechanically ventilated children were enrolled in a prospective cohort study. On the first and third days of mechanical ventilation, serum TSH, FT3, FT4 and reverse T3 were measured.
Results: The mean age of the studied patients was of 31.06 ± 35.94 months. After three days of mechanical ventilation, the serum levels of FT3 and FT4 in the blood were significantly lower than the serum levels on the first day. The serum reverse T3 levels increased significantly on the third day of mechanical ventilation compared to the first day. There was a statistically significant increase in the number of patients with low FT3 and FT4 serum levels on the third day compared to the first day. Twenty-two patients (64.7%) died, and the frequency of low FT3 among dead patients was signiisignificantlycantly higher than among surviving patients.
Conclusions: It could be concluded that the mechanically ventilated children had signs of euthyroid sick syndrome, shown by low levels of FT3 and FT4 and a rise in rT3 without a compensatory rise in TSH. Serum FT3 and FT4 decreased, but reverse T3 increased, on the third day of mechanical ventilation compared to the first day. Patients who had low FT3 levels died at a higher rate.