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  • 1
    Electronic Resource
    Electronic Resource
    Reduction of mortality rate in premature infants by substitution of thyroid hormones (1981)
    Springer
    European journal of pediatrics 135 (1981), S. 245-253 
    Details
    ISSN: 1432-1076
    Keywords: Transient hypothyroidism ; Prophylactic thyroid hormone substitution ; Neonatal intensive care ; Preterm infants ; Respiratory distress syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our previous examinations had shown that 9 of 13 premature infants with severe respiratory distress had hypothyroid T4-values. On the basis of these results a prospective study was initiated. Every second neonate born after less than 37 weeks gestation or weighing less than 2200 g and admitted to our intensive care unit since Janary 1979 received a prophylactic dose of 25 μg l-Thyroxine and 5 μg Tri-iodothyronine daily. Five of the patients inadvertently did not receive the drug and were included in the non-treated group which thus numbered 55. Both groups were nearly identical with regard to gestational age, birth weight and Apgar score. In the treated group of 45 infants three (=6.6%) died. In the untreated group of 55 infants 16 (=29%) died. The probability that the different mortality in the two groups was due to chance alone is less than 0.5% (χ2-test: P〈0.005). In 14 of the 55 non-treated patients transient hypothyroidism developed. Five patients with transient hypothyroidism and 2 patients with low T4-values without a TSH-increase were treated with thyroid hormone after ascertainment of their serum thyroxine levels and six survived. The analysis of the prophylactically treated cases showed that the dosage of 25 μg l-Thyroxine and 5 μg Tri-iodothyronine in critically ill infants (i.e., those who were mechanically ventilated or had sepsis) was rarely sufficient to produce normal serum thyroxine levels. In these children thyroxine usually rose to normal levels only when they had passed the acute stage of the disease. It therefore seems advisable to double the dose of thyroid hormone during the acute stage of the disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00442098
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Transient hypothyroidism associated with prematurity, sepsis, and respiratory distress (1979)
    Springer
    European journal of pediatrics 132 (1979), S. 85-92 
    Details
    ISSN: 1432-1076
    Keywords: Transient hypothyroidism ; Neonatal intensive care ; Preterm infants ; Respiratory distress syndrome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Serial TSH and T4 determinations were performed in sixty neonates admitted to our hospital for neonatal intensive care within a period of three months. Seven patients (12%) showed transient hypothyroidism on the basis of low T4 and high TSH values. Only one of these patients, who had meconium aspiration and pneumonia, did not have the respiratory distress syndrome. In addition, 4 of these patients had sepsis. All of the patients were born before 37 gestational weeks and had birth weight under 2200 g. In addition, two patients of this gestational age and birth weight group had a progressive fall of T4 to extremely hypothyroid values without simultaneous elevation of TSH. Two of the 5 patients who died had histological studies of their thyroids. These revealed colloid-depleted vesicles, desquamated epithelium, and prominent vascularisation of the thyroid. The results of this study show that early recognition and therapy of transient hypothyroidism may be live saving.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00447374
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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