JOURNAL OF PEDIATRIC CRITICAL CARE

Abstract

Title-Alterations of thyroid function in critically ill children Aims & Objective- To study thyroid hormonal changes in critically ill children and correlate them with outcome. Methods-In this prospective study total serum T3, T4and TSH levels were estimated at admission and at discharge or prior to death in fiftycritically ill cases admitted to PICU.Fifty healthy children were taken as controls. PRISMII score was used to predict outcome. Hormone levels were compared between cases and control and then between survivors and non survivors. Results- Mean T3 (59.86±16.09 vsl23.04±26.21)and T4 levels (5.38±1.30vs8.70±1.82) in cases were significantly (P-0.000) lower than that of controls,however no significant difference in the mean TSH values (2.21±1.91 vs2.18±1.06) were noted. Fourteen (28%) cases expired. Admission T3 level (44.71±13.35 Vs65.75±l3.01) was significantly (p-0.000) lower in non survivors than survivors but there was no significant difference in T4 (4.86±1.57Vs5.57±1.15) and TSH(2.17±1.69 Vs 2.28±2.12 ) levels. Serum T3 (65.75±13.01vs96.36±25.48),T4(5.57±1.15vs8.52±3.19) andTSHlevels(2.28±2.12 vs3.06±1.61)improved in survivors butfailed to improve innon survivors. LowT3 and T4 at admission were associated with high risk of mortality (odds ratio 14.8, p-0.000). PRISMII score and T4 in second sample were significant predictors of death. Conclusioii-In critically ill children T3, T4 levels are low, while TSH values may not change. T3 levels reflect patient’s clinical status and T4 levels can predict death.