Hypothyroidism prolong weaning

[coffeekat]

Dear all,

i came acorss some cases on bipap or ventilator, dr will check the thyroid function test occassionally; and i ve checked that ppl with hypothyroidism will prolonged their weaning from ventilator, so replacement of thyroxine can help. but why ppl on ventilator will more prone to hypothyroidism, is there any relationship between them?

thank you

[aCRNAhopeful]

Could it be that there are many people that go undiagnosed with hypothyroidism? I seem to remember that to be the case. So if they have weaning problems, they can rule that out as the cause. Just a thought.

[TakeBack]

Not a common cause of weaning failure. Pts w/ critical illness may have occult hypothyroidism.

http://chestjournal.chestpubs.org/content/126/4/1307.full

Results: Of 140 patients studied, 67 were male (48%) and 73 were female (52%), with a mean age of 66 + 15 years (± SD). Only one patient had a history of previously diagnosed hypothyroidism. A clinical diagnosis of hypothyroidism was made in 4 of 140 patients (3%) following admission. Serum TSH levels ranged from 0.19 to 121 mU/L in the studied subjects. Seventeen of 140 patients (12%) had elevated serum TSH levels. Serum tri-iodothyronine and/or thyroxine levels confirmed diagnosis of hypothyroidism in four of these patients (3%). Patients with newly diagnosed hypothyroidism were treated with thyroid supplements, and three patients were liberated from PMV while one patient died from other medical causes. Of the140 patients, 92 patients (67%) were liberated from PMV while 48 patients (33%) could not be weaned. Mean serum TSH levels were 4.2 + 13 mU/L in the liberated patients and 4 + 4.7 mU/L in the patients who could not be weaned (p = 0.25).

Conclusion: Hypothyroidism is an uncommon cause of failure to wean in patients receiving PMV (with an incidence of 3%). However, it is a potentially treatable cause and should be considered in all patients who fail to wean. Serum TSH level does not appear to affect successful weaning from PMV.