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      뇌사 장기 기증자에서 나타나는 갑상선 호르몬 변화 = Thyroid Hormonal Changes in Brain Death Donors

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      https://www.riss.kr/link?id=A103913765

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      다국어 초록 (Multilingual Abstract)

      Background: We analyzed thyroid hormone values in brain death patients to determine the need for thyroid hormone replacement therapy. Methods: We analyzed 111 brain death donors (77 males and 34 females, mean age, 41.1 years (range; 8 months−72 year...

      Background: We analyzed thyroid hormone values in brain death patients to determine the need for thyroid hormone replacement therapy.
      Methods: We analyzed 111 brain death donors (77 males and 34 females, mean age, 41.1 years (range; 8 months−72 years) in Ajou University Hospital from 2000 to 2010.
      Results: The mean values of thyroid hormones were T3; 72.5 ng/dl (normal range [NR] 60-181 ng/dl), T4; 5.0 μg/dl (NR 4.5−10.9 μg/dl), free T4 1.0 ng/dl (NR 0.8-1.5 ng/dl), and TSH 1.5 μIU/ml (NR 0.35−5.5 μIU/ml), respectively. However, the values of T4 (correlation coefficient −0.264, p = 0.005), free T4 (correlation coefficient −0.305, p = 0.001) and TSH (correlation −0.206, p = 0.031) significantly decreased based on the increase of interval from the brain death-inducing event to the evaluation time (hereafter, interval). The patients with greater than 8 days of interval (N = 30) showed significantly low thyroid hormone values compared to patients with less than 8 days of interval (N = 81); T3 (70.3 ng/dl vs. 77.0 ng/dl, p = 0.242), T4 (4.7 ng/dl vs. 5.3 ng/dl, p = 0.015), free T4 (0.8 ng/dl vs. 1.2 ng/dl, p = 0.006) and TSH (1.0 μIU/ml vs. 2.0 μIU/ml, p = 0.000), respectively.
      Conclusions: As the intervals from the brain death-inducing events increased, all thyroid hormone values of brain death donors except T3 significantly decreased. Therefore, we recommend that careful consideration should be given to the interval from brain death-inducing event for the evaluation of thyroid hormone status of brain death patients.

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      참고문헌 (Reference)

      1 Chen JM, "Vasopressin deficiency and pressor hypersensitivity in hemodynamically unstable organ donors" 100 (100): II244-246, 1999

      2 Novitzky D, "Value of triiodothyronine (T3) therapy to brain-dead potential organ donors" 5 : 486-487, 1986

      3 Salim A, "Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation" 21 : 405-409, 2007

      4 Randell TT, "Triiodothyronine treatment is not indicated in brain-dead multiorgan donors: a controlled study" 25 : 1552-1553, 1993

      5 Randell TT, "Triiodothyronine treatment in brain-dead multiorgan donors--a controlled study" 54 : 736-738, 1992

      6 Wheeldon DR, "Transforming the "unacceptable" donor: outcomes from the adoption of a standardized donor management technique" 14 : 734-742, 1995

      7 Goarin JP, "The effects of triiodothyronine on hemodynamic status and cardiac function in potential heart donors" 83 : 41-47, 1996

      8 Zuppa AF, "The effect of a thyroid hormone infusion on vasopressor support in critically ill children with cessation of neurologic function" 32 : 2318-2322, 2004

      9 Cooper DK, "Physiologic changes following brain death" 31 : 1001-1002, 1999

      10 Novitzky D, "Novel actions of thyroid hormone: the role of triiodothyronine in cardiac transplantation" 6 : 531-536, 1996

      1 Chen JM, "Vasopressin deficiency and pressor hypersensitivity in hemodynamically unstable organ donors" 100 (100): II244-246, 1999

      2 Novitzky D, "Value of triiodothyronine (T3) therapy to brain-dead potential organ donors" 5 : 486-487, 1986

      3 Salim A, "Using thyroid hormone in brain-dead donors to maximize the number of organs available for transplantation" 21 : 405-409, 2007

      4 Randell TT, "Triiodothyronine treatment is not indicated in brain-dead multiorgan donors: a controlled study" 25 : 1552-1553, 1993

      5 Randell TT, "Triiodothyronine treatment in brain-dead multiorgan donors--a controlled study" 54 : 736-738, 1992

      6 Wheeldon DR, "Transforming the "unacceptable" donor: outcomes from the adoption of a standardized donor management technique" 14 : 734-742, 1995

      7 Goarin JP, "The effects of triiodothyronine on hemodynamic status and cardiac function in potential heart donors" 83 : 41-47, 1996

      8 Zuppa AF, "The effect of a thyroid hormone infusion on vasopressor support in critically ill children with cessation of neurologic function" 32 : 2318-2322, 2004

      9 Cooper DK, "Physiologic changes following brain death" 31 : 1001-1002, 1999

      10 Novitzky D, "Novel actions of thyroid hormone: the role of triiodothyronine in cardiac transplantation" 6 : 531-536, 1996

      11 Ishikawa T, "Morphological and functional alterations in the adenohypophysis in cases of brain death" 11 (11): S234-237, 2009

      12 Jenkins DH, "Improving the approach to organ donation: a review" 23 : 644-649, 1999

      13 Mariot J, "Hormone levels, hemodynamics, and metabolism in brain dead organ donors" 27 : 793-794, 1995

      14 Novitzky D, "Hormonal therapy of the brain-dead organ donor: experimental and clinical studies" 82 : 1396-1401, 2006

      15 Novitzky D, "Hemodynamic and metabolic responses to hormonal therapy in brain-dead potential organ donors" 43 : 852-854, 1987

      16 Robertson KM, "Endocrine changes and haemodynamic stability after brain death" 21 : 1197-1198, 1989

      17 The Korean Society of Critical Care Medicine, "Critical Care Medicine" Koonja Publishing 585-, 2010

      18 Novitzky D, "Change from aerobic to anaerobic metabolism after brain death, and reversal following triiodothyronine therapy" 45 : 32-36, 1988

      19 Surks MI, "American Thyroid Association guidelines for use of laboratory tests in thyroid disorders" 263 : 1529-1532, 1990

      20 Rosendale JD, "Aggressive pharmacologic donor management results in more transplanted organs" 75 : 482-487, 2003

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      학술지 인용정보

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      2016 0.07 0.07 0.09
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      0.1 0.08 0.289 0.12
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