Thyroid axis disturbances in adult multi-trauma patients without traumatic brain injury.

Aim-Background: To evaluate thyroid axis TA hormone disturbances in adult multi-trauma patients (AMTP) without traumatic brain injury (TBI) and to correlate the results with other clinical and laboratory components of patient’s post-traumatic course. Material: Twenty-five AMTPs without TBI were included. The selection criteria commanded previously healthy individuals with class II–III haemorrhagic shock, requiring surgical control of bleeding, with no major post-operative complications, and no deaths. Methods: Blood was drawn for FT 3, FT 4 and TSH measurements at 24 & 72 hours post trauma, along with a full blood count, coagulation studies, and serum biochemical — hormone profile; the results were statistically assessed. Patients were also ranked with evaluation scores for disease severity and trend of clinical improvement over the following four days. Results: Most of the TSH & FT 4 levels were within normal range at both phases. Ebb phase thyroid hormones negatively correlated with APACHE III score, ADH, CRP levels and blood volume transfused at resuscitation. FT 3 levels were marginally lower than normal in patients with class III shock. Conclusions: Early appearance of euthyroid sick syndrome and disturbance of negative feed-back loop was observed at flow phase, with a prediction trend of FT 4 levels (flow) from ISS and SOFA score at 48 hs from ebb FT 3 levels. [ABSTRACT FROM AUTHOR]