ESPE Abstracts (2019) 92 P1-146

Is There Any Correlation Between Thyroid Function Test on First Day of Admission in Critically Ill Children and Disease Severity or Outcome?

Fatemeh Sayarifard1, Bahareh Yaghmaie2, Marjan Kouhnavard2, Azadeh Sayarifard3


1Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of. 2 Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran, Islamic Republic of. 3Community Based Participatory Research Center, Iranian Institute for Reduction of High Risk Behaviors, Tehran, Iran, Islamic Republic of


Sick euthyroid syndrome (SES) is the most common endocrine disorder in critically ill patients. It has been shown that the decrease in T4 levels correlates with disease severity and prognosis. Whether SES is a compensatory response to the disease course or needs to be treated is not known yet. To our knowledge, there are only a few studies oncritically ill infants and children investigating the correlation between thyroid function and disease severity as well as its outcome. Therefore, this study aimed to investigate thyroid hormone levels in critically ill patients.In this study, thyroid function tests including thyroid stimulating hormone (TSH), total T3 (TT3), free T3 (FT3), total T4(TT4), free T4 (FT4), and reverse T3 (rT3) were measured in 35 critically ill children admitted to intensive care unit (ICU) on days 1. Disease severity was evaluated using pediatric logistic organ dysfunction score (PELOD). Then the patients were divided into groups of survivors and non-survivors and the results were compared between these two groups accordingly. Thirty-five patients, including 19 (54.3%) female and 16 (45.7%) male, with the mean age of 2 years (SD: 3.8 years, range: 4 months- 15 years) had entered the study based on the inclusion criteria. 25 (71.6%) patients were transferred from PICU to other wards and 10 (28.4%) patients died. Age and sex were not statistically different in survivors and non-survivors (P > 0.05). It was revealed that there was a significant reduction in mean TT3 levels in non-survivors compared to survivors on the first day of admission (P =0.007). Conclusions: Thyroid function assessment, especially TT3 on the first day of admission, along with PELOD score, might be helpful in predicting disease outcome and patient's survival.

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