Article Text

FUNCTIONAL CONDITION OF THYROIDAL GLAND DURING SEPSIS CAUSED BY GRAM-NEGATIVE BACTERIA IN NEWBORNS
  1. N G Jincharadze1
  1. 1Children’s Central Hospital, Tbilisi, Georgia

Abstract

Objective The thyroid gland takes part in the adaptive/compensative response to organisms. Because of this, research of its functional status during sepsis in newborns is very useful.

Methods We studied 120 newborns, who had Gram-negative bacterial sepsis. This was an open prospective study, which was approved by the clinical bioethics commission. We studied thyroxin (T4), three-iodine thyronin (T3), thyroid-stimulating hormone (TSH), by radioimmunology methods. In the control group we included 30 healthy newborns. Detection of bacteria in blood was donee by real-time polymerase chain reaction.

Results During sepsis, thyroid gland hormone levels decreased: T4 ng/ml = 76.26±4.21 (N = 138.32±5.25); T3 ng/ml = 0.82±0.02(N = 2.27±0.18); Levels of TSH mk.un/l = 6.89±0.47 (N = 3.18±0.32) increased. During recovery, inclination of normalization of the thyroid gland function was shown, but was less than normal: T4 = 108.51±6.35 ng/ml; T3 = 1.16±0.08 ng/ml; TSH = 1.59±0.26 mk.un/l was decreased. In the clinical picture oedema (37%) and necrotizing of tissue (29%) were prevalent. Bacterial findings were: Serratia marcescens in 17, Pseudomonas aeruginosa in 25, Proteus mirabilis in 15, Klebsiella pneumoniae in 22, Escherichia coli in 21 and Acinetobacter in20. Research was statistically reliable (p<0.005).

Conclusions 1. During sepsis, the scheme of management must include hormone therapy with L-thyroxin 2. During sepsis, in the acute period of sepsis when there is hypofunction of thyroid gland, the hypophises reaction appeared adequate, but during the recovery period regulation of hypophises was repressed. 3. During sepsis the frequency of oedema syndrome and necrotizing of tissue is explained by hypofunction of the thyroidal gland.

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