Hypotension, Respiratory Failure
Conditions
Keywords
Thyroid Deficiency, Thyroid Stimulating Hormone
Brief summary
Thyroid hormones are substances naturally made by the body and are important to many of your body's basic functions such as breathing and brain function. We are investigating whether or not these hormones are at lower levels in critically ill children which could lead to further health problems. We hope to get a better understanding of hormone levels and their effects on critically ill children to better help other children in the future.
Detailed description
We hypothesize that critically ill children that require vasoactive infusions and/or invasive mechanical ventilation have thyroid hormone alterations. We will measure TSH, tT3, fT3, rT3, tT4, fT4, adn tyrosine concentrations in critically ill children with hypotension and/or respiratory failure and correlate thyroid hormone alterations to severity of illness, intensity of therapeutic interventions, and associated morbidity and mortality by using clinical outcomes parameters.
Interventions
OTHERBlood draws
17 mls of blood will be drawn over a 5 day period from either a central venous catheter/arterial line or with scheduled phlebotomy. The following labs will be run tT3, fT3, rT#, tT4, fT4, TSH, and tyrosine.
Sponsors
Children's Hospital of Philadelphia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
12 Months to 18 Years
Healthy volunteers
No
Inclusion criteria
* Informed Consent * Age of less than 12 months and less than or equal to 18 * Patient must weigh greater than 10 kgs. * Patients must require vasoactive infusions and/or mechanical ventilation. * Patients must be enrolled within 24 hours of meeting eligibility.
Exclusion criteria
* Patient with known or presumed pre-existing thyroid disease will be excluded * Patients who receive thyroid supplementation will be excluded * Patients with known or presumed hypothalamic and/or pituitary dysfunction that have thyroid hormone concentration abnormalities not related to an acute illness. * Patients who are intubated for airway protection only. * Patients intubated for neuromuscular disease * Pregnant patients. * Patients receiving amiodarone supplementation * Patients who received blood product transfusions equaling more than 1/2 of their blood volume.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Certain critically ill children requiring vasoactive infusions and/or mechanical ventilation have low concentrations of tT3, fT3, tT4, fT4, elevated rT3, adn inappropriate low/normal TSH. | When patient has completed the study. |
Secondary
| Measure | Time frame |
|---|---|
| Critically ill children with more severe thyroid hormone deficiencies will have greater severity of illness, intensity of therapeutic intervention, organ dysfunction, and increased morbidity and mortality. | When study is completed. |
| Critically ill children requiring vasoactive infusions and/or mechanical ventilation are a population in the ICU that has thyroid hormone pertubation and significant morbidity and mortality. | At completion of study |
Countries
United States
Outcome results
None listed