Thyroid hormone response to moderate hypothermia in severe brain injury.
OBJECTIVE
To examine the effect of controlled moderate hypothermia on thyroid response in head-injured patients.


METHODS
Prospective, controlled, randomized study.


METHODS
University hospital intensive care unit (ICU).


METHODS
Twenty-eight patients with severe blunt head injury (Glasgow Coma Scale < or =9).


METHODS
Patients were randomly assigned to a hypothermia or a normothermia group. Hypothermia (32-33 degrees C) was induced within 8 h after trauma and maintained for a mean of 36 h. All patients were sedated and mechanically ventilated.


RESULTS
Thyroid-stimulating hormone( TSH), free and total triiodothyronine (FT3/TT3), reverse triiodothyronine (RT3) and thyroxine (FT4/TT4) were measured during the hypothermia or corresponding normothermia period, after regaining normothermia and 4-6 days later. Of 28 patients included in the study, 11 subjects were treated with hypothermia and 13 patients with normothermia. Four patients had to be excluded. In both groups, serum concentrations of TT3 and FT3 were just below the lower normal range whereas RT3 serum concentrations were near the upper limit of the normal range. TSH serum concentrations were not increased. No statistically significant intra- or inter-group differences were observed.


CONCLUSIONS
Thyroid hormone patterns during moderate hypothermia in head-injured patients did not differ from the well known "low T3 state" which is observed in other forms of severe illness.
Meissner
Winfried
W
Department of Anesthesiology and Intensive Care, Friedrich Schiller University Jena, Bachstrasse 18, 07740 Jena, Germany. meissner@med.uni-jena.de
Krapp
Clemens
C
Kauf
Eberhard
E
Dohrn
Barabara
B
Reinhart
Konrad
K
D000328:Adult; D001930:Brain Injuries / Q000628:therapy*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007362:Intensive Care Units; D008297:Male; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013963:Thyroid Hormones / Q000097:blood*; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D014949:Wounds, Nonpenetrating / Q000628:therapy*
D013963:Thyroid Hormones; D014284:Triiodothyronine; D013974:Thyroxine