Non-thyroidal
illness syndrome (NTIS or euthyroid sick syndrome) is a
complex endocrine condition that may occur in critically
ill patients. It is associated with significantly
increased morbidity and mortality.
NTIS
is characterised by three components that may occur
single or in combination:
1.
central hypothyroidism (transient thyrotropic
insufficiency)
2. impaired protein binding of thyroid hormones
and
3. reduced formation of T3 and increased conversion to
rT3 (low-T3-syndrome).
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 NTIS 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.
Therefore,
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 NTIS will be
determined.
This
project is intended to:
1.
deliver a prognostical aid by providing a
differentiated classification,
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
therapy.
The AQUA FONTIS study is registered in the database ClinicalTrials.gov
of NIH
(number NCT00591032).
