Myxedema coma: a new look into an old crisis.

摘要: Myxedema crisis is a severe life threatening form of decompensated hypothyroidism which associated with high mortality rate. Infections and discontinuation thyroid supplements are the major precipitating factors while hypothermia may not play role in tropical countries. Low intracellular T3 leads to cardiogenic shock, respiratory depression, coma. Patients identified on basis low index suspicion careful history examination focused features factors. Arrythmias coagulation disorders increasingly being myxedema crisis. Thyroid replacement should be initiated as early possible attention hypotension, fluid steroid an intensive care facility. Studies have shown that hormone through ryles tube loading dose maintenance therapy efficacious intravenous therapy. In many countries available oral T4 can used effectively without significant difference outcomes. Hypotension, bradycardia at presentation, need for mechanical ventilation, unresponsive treatment, sepsis, intake sedative drugs, lower GCS APACHE II scores Sequential Organ Failure Assessment (SOFA) more than 6 predictors Early intervention hypothyroid patients developing sepsis other ensuring continued prevent morbidity