Nonthyroidal illness syndrome and prolonged mechanical ventilation in patients admitted to the ICU

Mariano Alberto Pennisi, Luca Montini, Massimo Antonelli, Giuseppe Bello, Serena Silva, Riccardo Maviglia, Fabio Cavallaro, Antonio Bianchi, Laura De Marinis Grasso

Risultato della ricerca: Contributo in rivistaArticolo in rivista

48 Citazioni (Scopus)

Abstract

BACKGROUND: The effect of the nonthyroidal illness syndrome (NTIS) on the duration of mechanical ventilation (MV) has not been extensively investigated. This study aims to determine whether the NTIS is associated with the duration of MV in patients admitted to the ICU. METHODS: We evaluated all patients admitted over a 6-year period to our ICU who underwent invasive MV and had measurement of serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) performed in the first 4 days after ICU admission and, subsequently, at least every 8 days during the time they received MV. The primary outcome measure was prolonged MV (PMV), which was defined as dependence on MV for > 13 days. RESULTS: Two hundred sixty-four patients were included. Fifty-six patients (normal-hormone group) had normal thyroid function test results, whereas 208 patients (low-fT3 group) had, at least in one hormone dosage, low levels of fT3 with normal (n = 145)/low (n = 63) levels of fT4 and normal (n = 189)/low (n = 19) levels of TSH. Patients in the low-fT3 group showed significantly higher mortality and simplified acute physiology score II, and significantly longer duration of MV and ICU length of stay compared with the normal-hormone group. Two of the variables studied were associated with PMV, as follows: the NTIS (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.18 to 4.29; p = 0.01); and the presence of pneumonia (OR, 1.17; 95% CI, 1.06 to 3.01; p = 0.03). CONCLUSION: The NTIS represents a risk factor for PMV in mechanically ventilated, critically ill patients. PMID: 19255297 DOI: 10.1378/chest.08-1816
Lingua originaleEnglish
pagine (da-a)1448-1454
Numero di pagine7
RivistaChest
Volume135
DOI
Stato di pubblicazionePubblicato - 2009

Keywords

  • Age Distribution
  • Aged
  • Analysis of Variance
  • Cohort Studies
  • Critical Care
  • Critical Illness
  • Euthyroid Sick Syndromes
  • Female
  • Humans
  • Incidence
  • Intensive Care Units
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Probability
  • Prognosis
  • Respiration, Artificial
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Statistics, Nonparametric
  • Survival Analysis
  • Thyroid Function Tests
  • Thyrotropin
  • Time Factors

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