Non-thyroidal illness syndrome (NTIS), also referred to as euthyroid sick syndrome (ESS) or thyroid allostasis in critical illness, tumours, uraemia and starvation (TACITUS) is a complex endocrine condition that may occur in critically ill patients. It is associated with significantly increased morbidity and mortality.
is characterised by three components that may occur
single or in combination:
central hypothyroidism (transient thyrotropic
2. impaired protein binding of thyroid hormones
3. reduced formation of T3 and increased conversion to
Despite of long lasting research to some of its details, NTIS is still poorly characterized in an integrative view. Additionally, it lacks a clinically usable classification.
Given the fact that patients with TACITUS are faced with poor prognosis, several studies have been conducted in the past evaluating the question of possible treatment. However, they didn't yield unambiguous results, maybe due to the fact that these studies did not differentiate among the distinct components of NTIS.
this study is intended to develop a clear-cut definition
and classification of NTIS in order to set a foundation
for future therapeutic studies.
This study recruits critically ill patients treated in medical and surgical intensive care units of the Bergmannsheil University hospitals for evaluation of integrative thyrotropic control and follow-up. From these data the correlation of individual prognosis with laboratory-defined components of TACITUS will be determined.
project is intended to:
deliver a prognostical aid by providing a
2. to contribute to a standardised, rational and
inexpensive diagnostical procedure and
3. to lay the foundation for future therapeutic trials
by identifying subgroups that may benefit from
The AQUA FONTIS study is registered in the database ClinicalTrials.gov