| Early recognition of myxedematous respiratory failure in the elderly. | |
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MedLine Citation:
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PMID: 19371530 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To report the clinical characteristics of myxedematous respiratory failure in the elderly and to facilitate early recognition of hypothyroidism in critically ill old patients. METHODS: Clinical characteristics of our reported 4 patients and that of 17 patients with myxedematous respiratory failure reported previously were reviewed. Demographic information, vital signs, basic laboratory studies, and blood gas analysis were compared. RESULTS: All 4 patients were older than 60 years and were hypoxic and hypercarbic upon presentation. All were found to have either anemia or marked electrolyte abnormalities and markedly elevated levels of thyroid-stimulating hormone once these levels were evaluated. Three of the 4 patients presented with profound lethargy and/or constipation, slowed intellectual ability, and dry skin. CONCLUSIONS: Early recognition of hypothyroidism in elderly patients with myxedematous respiratory failure is crucial to prognosis. Whereas hypothermia, myxedema, and a history of thyroid disease mandate the thyroid function tests in patients with type 2 respiratory failure, the following 5 elements also warrant the thyroid function tests: bradycardia, anemia, hyponatremia, pleural or pericardial effusion, and a history of weight gain. Where mechanical ventilation has been applied, patients with difficult weaning from ventilator support should also be evaluated and screened for hypothyroidism. |
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Authors:
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Fuping Guo; Tengda Xu; Houli Wang |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 27 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2009 Feb |
Date Detail:
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Created Date: 2009-04-17 Completed Date: 2009-05-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 212-5 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Tsinghua University, Beijing 100730, PR China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Blood Gas Analysis Diagnosis, Differential Early Diagnosis Female Humans Hypothyroidism / diagnosis* Male Middle Aged Myxedema / diagnosis* Respiratory Insufficiency / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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