The role of hypothyroidism in weaning patients from mechanical ventilation: a clinical trail

Majid Montazer,Arezoo Fathalizadeh,Karmran Shadvar,Jalal Farmani

doi:10.34172/jrcm.2020.042

Majid Montazer, Arezoo Fathalizadeh + Show 2 more

Open Access

https://doi.org/10.34172/jrcm.2020.042

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Abstract

Objective: Hypothyroidism is a relatively common disease around the world; and as a clinical condition due to the lack of secretion of thyroid hormone from the thyroid gland, due to some structural and/or functional disorders, thyroid hormone production is defined. The purpose of this study is to investigate the isolation of the problem of mechanical ventilation caused by hypothyroidism in hospitalized patients. Methods: In this clinical trial, 80 patients admitted to the ICU ward of Imam Reza Hospital and intubated for more than one week were studied. Patients were classified into two subgroups (each subgroup was 40). Levothyroxine was prescribed for the case group 0.1 mg of the first morning; while no Levothyroxine was prescribed to the patients in the control group. Differences between the two groups is evaluated in the time of weaning. Results: There was a significant difference between two groups regarding TSH, T3 and T4. There was also a significant difference between final outcome of the patients and time of weaning from the mechanical ventilation between the two groups; which can be attributed to the effect of the role of levothyroxine on the recovery of patients and the reduction of weaning from mechanical ventilation. Conclusion: The thyroid function of intubated patients should be monitored to be kept in normal levels to accelerate the recovery of these patients or in some cases prevent them from deterioration.

Highlights

Hypothyroidism is a relatively common disease around the world in which the production of thyroid hormone is diminished due to some structural and/or functional disorders
There was a significant difference between final outcome of the patients and time of weaning from the mechanical ventilation between the two groups; which can be attributed to the effect of levothyroxine on the recovery of patients and the reduction of weaning from mechanical ventilation
The mechanisms of respiratory failure caused by hypothyroidism include: 1) respiratory disturbance in response to hypoxia and hypercarbia; 2) hypercapnia leading to respiratory muscle disorder; 3) obstructive sleep apnea syndrome (OSAS)

Summary

Introduction

Hypothyroidism is a relatively common disease around the world in which the production of thyroid hormone is diminished due to some structural and/or functional disorders. Prolonged hospital stay in patients admitted to the ICU is currently one of the common problems in hospitals Some of these patients are often difficultly weaned from the mechanical ventilation due to weaning challenges.[1] There is an increasing body of evidence that delayed weaning can cause undesirable complications and cost of treatment. Respiratory complications occur in patients with hypothyroidism Symptoms such as dyspnea, sleep apnea, diaphragmatic dysfunction, hypoxia, hypercapnia, and muscle dysfunction have been broadly reported. The mechanisms of respiratory failure caused by hypothyroidism include: 1) respiratory disturbance in response to hypoxia and hypercarbia; 2) hypercapnia leading to respiratory muscle disorder; 3) obstructive sleep apnea syndrome (OSAS). Respiratory failure often occurs following neuroendocrine activation by altered serum T4, T3, and TSH levels.

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