ADRENAL AND THYROID DYSFUNCTION IN NON-TRAUMATIC SUBARACHNOID HEMORRHAGE REQUIRING THERAPEUTIC NORMOTHERMIA. CLINICAL OBSERVATION

被引：0

作者：

Altshuler, N. E. ^{[1
]}

Kruglyakov, N. M. ^{[3
]}

Bagzhanov, G. I. ^{[4
]}

Popugaev, K. A. ^{[6
,7
,8
]}

Kutcyi, M. B. ^{[2
]}

Anikyeva, E. A. ^{[5
]}

Dokukin, A. A. ^{[5
]}

机构：

[1] Medicobiol Univ Innovat & Continuing Educ Fed Med, Medicobiol Univ Innovat & Continuing Educ, AI Burnasyan Fed Med Biophys Ctr FMBA, Fed Med Biophys Ctr AI Burnazyan, Moscow, Russia

[2] Operat Ctr, European Med Ctr, Moscow, Russia

[3] ABB GISPL India, Anesthesia & Intens Care Serv, Moscow, Russia

[4] Medicobiol Univ Innovat & Continuing Educ, Dept Anesthesia & Intens Care, AI Burnazyan Fed Med Biophys Ctr FMBA, AI Burnazyan Fed Med & Biophys Ctr FMBA,Ophthalmo, Moscow, Russia

[5] European Med Ctr, Moscow, Russia

[6] NV Sklifosovskii Res Inst Emergency Med, Moscow Healthcare Dept, Intens Care, Moscow, Russia

[7] NV Sklifosovskii Res Inst Emergency Med, Moscow Healthcare Dept, Reg Vasc Ctr, Moscow, Russia

[8] AI Burnasyan Fed Med Biophys Ctr FMBA, Dept Anesthesiol, Resuscitat Intens Care, Moscow, Russia

来源：

YAKUT MEDICAL JOURNAL | 2023年 / 03期

关键词：

critical illness; hypothyroidism; thyrotropin; thyroid hormones; thyroxine; triiodo-thyronine; extracorporeal membrane oxygenation; targeted temperature management; cortisol; adrenocorticotropic hormone;

D O I：

10.25789/YMJ.2023.83.30

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Subarachnoid hemorrhage (SAH) is a life-threatening variant of hemorrhagic stroke. Therapeutic normothermia to reduce the risk of adverse outcomes. At the same time, the initially existing decompensation of body systems, followed by induced normothermia, gives impetus to the development of a number of pathophysiological processes in the human body. Objective. Timely detection and adequate correction of endocrinopathy of critical illness in patients in the most acute period of SAH against the background of therapeutic normothermia with a target temperature regime of 36 degrees C. Materials and methods. A 57-year-old patient with a diagnosis of non-traumatic subarachnoid hemorrhage, saccular aneurysm of the anterior communicating artery and anterior cerebral artery, Hunt Hess III. Results. The development of critically ill adrenal dysfunction considered based on the need for vasopressors. Thyroid dysfunction caused by a critical illness considered with a decrease in the level of TSH and free T3 in blood plasma against the background of therapeutic normothermia, the development of intestinal dysfunction and sinus bradycardia. Conclusions. Against the background of the introduction of hydrocortisone at an initial dose of 300 mg, the administration of norepinephrine discontinued on the third day. When levothyroxine sodium 300 mcg/day added to therapy, intestinal dysfunction resolved, normal resting heart rate achieved.

引用

页数：121