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- W2964652714 abstract "Purpose of review This review summarizes recent literature on nonthyroidal illness syndrome (NTI) and outcome of pediatric critical illness, to provide insight in pathophysiology and therapeutic implications. Recent findings NTI is typically characterized by lowered triiodothyronine levels without compensatory TSH rise. Although NTI severity is associated with poor outcome of pediatric critical illness, it remains unclear whether this association reflects an adaptive protective response or contributes to poor outcome. Recently, two metabolic interventions that improved outcome also altered NTI in critically ill children. These studies shed new light on the topic, as the results suggested that the peripheral NTI component, with inactivation of thyroid hormone, may represent a beneficial adaptation, whereas the central component, with suppressed TSH-driven thyroid hormone secretion, may be maladaptive. There is currently insufficient evidence for treatment of NTI in children. However, the recent findings raised the hypothesis that reactivation of the central NTI component could offer benefit, which should be tested in RCTs. Summary NTI in critically ill children can be modified by metabolic interventions. The peripheral, but not the central, component of NTI may be a beneficial adaptive response. These findings open perspectives for the development of novel strategies to improve outcome of critical illness in children." @default.
- W2964652714 created "2019-08-13" @default.
- W2964652714 creator A5004123840 @default.
- W2964652714 creator A5036267148 @default.
- W2964652714 creator A5042145557 @default.
- W2964652714 date "2019-10-01" @default.
- W2964652714 modified "2023-10-14" @default.
- W2964652714 title "Nonthyroidal illness in critically ill children" @default.
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- W2964652714 doi "https://doi.org/10.1097/med.0000000000000494" @default.
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- W2964652714 hasPublicationYear "2019" @default.
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