COMBINED CRITICAL ILLNESS–RELATED CORTICOSTEROID AND THYROID INSUFFICIENCY DURING TARGETED TEMPERATURE MANAGEMENT: A PROSPECTIVE COHORT STUDY

Abstract

Objective. To study the effect of therapy for adrenal and thyroid dysfunction on the course and outcomes of critical care. Materials and methods. 51 patients requiring targeted temperature management (ТТМ) were included in a single-center prospective cohort study. Results. Group I (with adrenal and thyroid dysfunction) included 39 (76,5%) patients on TTM, group II (without adrenal and thyroid dysfunction ) included 12 (23,5%) patients without endocrinopathies. In patients on TTM, adrenal dysfunction developed on day (D) 0 and manifested only clinically in the form of vascular insufficiency. When evaluating clinical and laboratory data in patients at TTM, thyroid dysfunction was diagnosed at D1, D2, and D3. The manifestation of adrenal and thyroid dysfunction in patients at is primarily due to central nervous system injury rather than sepsis. Treatment of adrenal and thyroid dysfunction was performed with hydrocortisone and levothyroxine. Conclusion. Formation of combination of adrenal and thyroid dysfunction at TTM leads to the development of multiple organ dysfunction not associated with the development of septic complications. Timely diagnosis and adequate correction of adrenal and thyroid dysfunction in patients undergoing critical illness and requiring TTM allows to reliably reduce mortality.