THYROID-HORMONE LOSS AND REPLACEMENT DURING RESUSCITATION FROM CARDIAC-ARREST IN DOGS

被引：24

作者：

FACKTOR, MA

MAYOR, GH

NACHREINER, RF

DALECY, LG

机构：

[1] Department of Physiology The University, Michigan Medical School, Ann Arbor, MI 48109, 7799 Medical Sciences Bldg. II

[2] Boots Pharmaceuticals, Inc., Lincolnshire

[3] Endocrine Diagnostic Section, College of Veterinary Medicine, Michigan State University, East Lansing

[4] Department of Surgery, The University of Michigan Medical School, Ann Arbor

来源：

RESUSCITATION | 1993年 / 26卷 / 02期

关键词：

HYPOTHYROID; EUTHYROID SICK SYNDROME; NEUROLOGIC DEFICIT; GLOBAL CEREBRAL ISCHEMIA;

D O I：

10.1016/0300-9572(93)90174-O

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Circulating concentrations of thyroxine (T4), triiodothyronine (T3), and reverse triiodothyronine (rT3) were followed in dogs subjected to 9 min of normothermic ventricular fibrillation. Significant decreases were detected 12 h post-arrest when compared to pre-arrest levels in total T4 (P < 0.0005), free T4 (P < 0.0005), total T3 (P < 0.003), and free T3 (P < 0.003), and levels of reverse T3 were significantly elevated (P = 0.0001). Similar changes occurred with only 30 s of arrest. Post-arrest replacement therapy with 7.5 mug/kg per h (Rx-7.5) and 15 mug/kg per h (Rx-15) levothyroxine sodium (L-T4) increased total T4, free T4, and total T3 (P < 0.01). Free T3 decreased in the Rx-7.5 group (P < 0.01) and did not fall in the Rx-15 group (P = 0. 16). Reverse T3 increased with either treatment (P < 0.005). Both treatment groups had higher levels of all five hormones than non-treated animals (P < 0.001). Neurologic function, assessed with a standardized scoring system, showed significant improvement in the treated groups by 6 h (P < 0.05, compared to non-treated group) and remained significant through 24 h post-arrest (P < 0.05). The documentation of rapid and dramatic changes in thyroid hormones immediately following cardiac arrest and resuscitation indicates a significant acute hypothyroid state that may potentially benefit from replacement therapy.

引用

页码：141 / 162

页数：22

共 48 条

[1]

Wortsman, Premachandra, Chopra, Murphy, Hypothyroxinemia in cardiac arrest, Arch Intern Med, 147, pp. 245-248, (1987)

[2]

Chopra, Solomon, Hepner, Morgenstein, Misleadingly low free thyroxine index and usefulness of reverse triiodothyronine measurement in nonthyroidal illnesses, Ann Intern Med, 90, pp. 905-912, (1979)

[3]

Faber, Kirkegaard, Lumholtz, Siersbaek-Nielsen, Friis, Variations in serum T3, rT3, 3,3′-diiodothyronine and 3′,5′-diiodothyronine induced by acute myocardial infarction and propranolol, Acta Endocrinol, 94, pp. 341-345, (1980)

[4]

Wiersinga, Lie, Touber, Thyroid hormones in acute myocardial infarction, Clin Endocrinol, 14, pp. 367-374, (1981)

[5]

Kahana, Keidar, Sheinfeld, Palant, Endogenous cortisol and thyroid hormone levels in patients with acute myocardial infarction, Clin Endocrinol, 19, pp. 131-139, (1983)

[6]

Franklyn, Gammage, Ramsden, Sheppard, Thyroid status in patients after acute myocardial infarction, Clin Sci, 67, pp. 585-590, (1984)

[7]

Novitzky, Matthews, Shawley, Cooper, Zuhdi, Triiodothyronine in the recovery of stunned myocardium in dogs, Ann Thorac Surg, 51, pp. 10-17, (1991)

[8]

Baue, Gunther, Hartel, Ackenheil, Heberer, Altered hormonal activity in severely ill patients after injury or sepsis, Arch Surg, 119, pp. 1125-1132, (1984)

[9]

Zaloga, Chernow, Smallridge, Zajtchuk, Hall-Boyer, Hargraves, Lake, Burman, A longitudinal evaluation of thyroid function in critically ill surgical patients, Ann Surg, 201, 4, pp. 456-464, (1985)

[10]

Robuschi, Medic, Fesani, Barboso, Montermini, d'Amato, Gardini, Borciani, Dall'Aglio, Salvi, Gnudi, Roti, Cardiopulmonary bypass: “a low T4 and T3 syndrome” with blunted thyrotropin (TSH) response to thyrotropin releasing hormone (TRH), Horm Res, 23, pp. 151-158, (1986)

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