Paediatrica Indonesiana
Vol 59 No 6 (2019): November 2019

Triiodothyronin (T3) as a parameter of mortality in sepsis patients in the PICU

Sri Wahyuni Djoko (Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali)
Nyoman Budi Hartawan (Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali)
Bagus Ngurah Putu Arhana (Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali)
Eka Gunawijaya (Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali)
Anak Agung Ngurah Ketut Putra Widnyana (Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali)
Dyah Kanya Wati (Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali)



Article Info

Publish Date
18 Nov 2019

Abstract

Background Thyroid hormone stimulates the regulation of β-adrenergic receptors in order to increase the inotropic effect of the heart myocardium. Euthyroid sick syndrome is a disorder of non-metabolic thyroid function, which is characterized by a decrease in triiodothyronine (T3) levels in patients with non-thyroid systemic disease, such as sepsis. Low serum T3 hormone level is a potentially high-risk factor for mortality from sepsis. Objective To assess for a relationship between decreased serum T3 levels and mortality in pediatric sepsis patients admitted in the PICU. Methods This study used a nested case-control design. The subjects were children aged 1 month-18 years who were diagnosed with sepsis in the pediatric intensive care unit at Sanglah Hospital, Denpasar, Bali, from September 2017 to January 2019. Results A total of 90 children were included, of whom 44 died and 46 survived. Median age was 10.5 (IQR 44) months in subjects who died and 9 (IQR 50) months in those who survived. The majority of subjects in both groups had well-nourished nutritional status. Bivariate analysis revealed that significantly more subjects who died had low serum T3 (≤1 ng/dL), PELOD-2 score ≥5, than subjects who survived. Multivariate analysis revealed that serum T3 £1 ng/dL (OR 55.1; 95%CI 9 to 334.8; P<0.001) and PELOD-2 score ³5 (OR 6.5; 95%CI 1.6 to 26.7; P=0.01) were significant risk factors for sepsis mortality. Conclusion Low serum T3 level and high PELOD-2 score are risk factors for death in sepsis.

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Journal Info

Abbrev

paediatrica-indonesiana

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of ...