Thyroid hormone profile and PELOD score in children with sepsis
Journal Title: Paediatrica Indonesiana - Year 2014, Vol 54, Issue 4
Abstract
Background Thyroid hormonal dysfunction, also known aseuthyroid sick syndrome or nonthyroidal illness, can be seenin sepsis. There have been few studies on thyroid hormonedysfunction in septic children, as well as on a relationshipbetween their thyroid hormone profiles and pediatric logisticorgan dysfunction (PELOD) scores. Procakitonin (PCT) is oneof the sepsis biomarker.Objective To evaluate the thyroid hormone profile in childrenwith sepsis as well as to assess for a correlation between the thyroidlevels and PELOD scores, PCT levels, and patient outcomes.Methods This cross-sectional study included children aged 1- 18years admitted to the pediatric intensive care unit (PICU) with aprimary diagnosis of sepsis. PELOD scores and thyroid hormonallevels were assessed once during the first 24 hours after PICUadmission.Results Thirty subjects were included in the study. The medianvalues ofT3, free T4, and TSH were 45 (range 17 -133) ng/dL,0.81 (range 0.3-1.57) ng/dL, and 1.36 (range 0.05-7.78) μIU/L,respectively. The T3, free T4, and TSH levels were decreased in97%, 50% and 40% of the subjects. There were no significantdifferences between low and normal to high TSH with regards tothe PELOD score (P=0.218), PCT level (P=0.694), or patientoutcomes (P=0.55). The risk of death increased by 15 timesamong the subjects with PELOD score ~20 compared to thosewith PELOD score <20 (OR 15; 95%CI: 1.535 to 146.545;P=0.012).Conclusion Thyroid hormones are decreased in septic childrenwith the majority having low T3. A high PELOD score is stronglycorrelated with mortality and can be used as a prognostic parameterfor septic children in the PICU, but there is no correlation withdecreased TSH.
Authors and Affiliations
Agung Tanurahardja, Antonius Pudjiadi, Pramita Dwipoerwantoro, Aman Pulungan
Keywords
Related Articles
- EP ID EP458737
- DOI 10.14238/pi54.4.2014.245-50
- Views 77
- Downloads 0
Ferric sodium edetate therapy in children with iron deficiency anemia
Background Iron deficiency anemia (IDA) is frequentlyfound in school-aged children. The main treatments for IDAare overcoming the causal factors and iron supplementation.Noncompliance in taking iron tablets and the possi...
Preterm infant physiological responses to music therapy: a systematic review
Background Prematurity is still the leading cause of mortality and morbidity in neonates. The premature change of the environment causes stress, which leads to hemodynamic instability. Music therapy may have a positive i...
Corticosteroids and obesity in steroid-sensitive and steroid-resistant nephrotic syndrome
Background Children with nephrotic syndrome need high-dose corticosteroids to achieve remission. Studies have estimated a 35-43% risk of obesity in these patients after corticosteroid treatment.Objective To determine the...
Anemia among children and adolescents in a rural area
Background Anemia in children and adolescents affects growthand development. It is a preventable disease, but unfortunately isoften ignored until the symptoms occur. There have been limitedreports on the prevalence of an...
Screening for nutritional risk in hospitalized children: comparison of two instruments
Background Malnutrition in hospitalized children has negative impact on morbidity, mortality, length of stay, and health-care cost. A simple screening tool is needed to detect hospital malnutrition risk in children.Objec...