Association Between Thyroid Dysfunction and Intensive Care Unit Acquired Weaknesss

Last updated: March 17, 2020
Sponsor: Ain Shams University
Overall Status: Active - Recruiting

Phase

N/A

Condition

Thyroid Disorders

Treatment

N/A

Clinical Study ID

NCT04313101
FMASU R 10/2020
  • Ages > 18
  • All Genders

Study Summary

Intensive care unit-acquired weakness (ICU-AW) is the most common neuromuscular impairment in critically ill patients. It affects more than 50 % of patients in the intensive care and is related to many problems as difficult weaning from mechanical ventilation, prolonged hospital stay and increased mortality.Thyroid disorders are also associated with neuromuscular abnormalities and may decrease the threshold for the development of any type of myopathy. However, no previous study investigated the direct relationship between thyroid dysfunction and ICUAW.This study aims at evaluation of the association between thyroid dysfunction and intensive care unit acquired weakness.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients of both sexes admitted to the general ICU of Ain Shams University Hospitalswith critical illness for more than 7 days * Diagnosis of ICU acquired weakness willbe made based on clinical criteria for ICUAW and confirmed by nerve conductionstudies.

Exclusion

Exclusion Criteria:

  • Patients with cerebrovascular accidents, neuromuscular disorders, spine abnormalities,spinal cord or head injuries, CNS tumors, secondary thyroid disorders and electrolytedisturbances were excluded from the study. Patients receiving thyroid replacement oranti-thyroid drugs for the treatment of any throid disorder will be also excluded fromthe study as these drugs may alter their thyroid biochemistry

Study Design

Total Participants: 114
Study Start date:
February 20, 2020
Estimated Completion Date:
May 31, 2020

Study Description

Intensive care unit acquired weakness refers to muscle weakness encountered in the intensive care unit as a consequence of critical illness. It affects more than 50 % of patients in the intensive care and is related to many problems as difficult weaning from mechanical ventilation, prolonged hospital stay and increased mortality.

There are three distinct entities for ICUAW that can only be differentiated by neurophysiological studies. These are critical illness myopathy (CIM), critical illness polyneuropathy (CIP) and critical illness neuromyopathy (CINM).

Identification of risk factors responsible for the development of ICUAW is the first step in the prevention and management of this disorder. Till time septic shock, hyperglycemia, high dose steroid therapy, prolonged mechanical ventilation and the use of neuromuscular blocking agents are the main accused.

Thyroid disorders are also associated with neuromuscular abnormalities. Unfortunately, the prevalence of thyroid dysfunction in the intensive care is high reaching 90%. Moreover, patients with severe critical illness, who are typically prone to the development of ICUAW, show changes in their thyroid biochemistry namely low T3 levels (with or without low T4 levels) in the presence of normal TSH levels. These changes are collectively known as Non-Thyroidal illness syndrome (previously low T3 syndrome and Euthyroid sick syndrome) which is the most common form of thyroid dysfunction in the intensive care unit.

Connect with a study center

  • Ain Shams University hospitals

    Cairo, Abbaseya 11566
    Egypt

    Active - Recruiting

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