A review of thyroid hormone administration during adult donor care.
Serum concentrations of thyroid hormones tetraiodothyronine and triiodothyronine commonly are low after head injury and brain death. Thyroid hormone replacement therapy, however, is a controversial part of donor management. This article reviews publications in which thyroid hormone administration was evaluated in human donors. A classification of the "quality" of study methods used in those publications is presented as part of the data review. No publications support the routine administration of thyroid hormone for all donors. "Rescue" replacement in support of cardiac inotropic function is supported by some studies, but the experimental design of those investigations is not optimal. Thyroid hormone replacement and its dosing should be decided by organ procurement organizations as part of treatment protocols.
Powner
David J
DJ
Department of Neurosurgery and School of Public Health (MH), University of Texas Health Science Center, Houston, TX, USA.
Hernandez
Michael
M
D000328:Adult; D001926:Brain Death / Q000378:metabolism*; D002985:Clinical Protocols; D020249:Hormone Replacement Therapy / Q000379:methods* / Q000592:standards; D006801:Humans; D008020:Life Support Care / Q000379:methods; D018579:Patient Selection; D012107:Research Design / Q000592:standards; D013963:Thyroid Hormones / Q000502:physiology / Q000627:therapeutic use*; D013997:Time Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000592:standards; D016896:Treatment Outcome
D013963:Thyroid Hormones