Free T4, free T3, and reverse T3in critically III, thermally injured patients

Richard A. Becker, Douglas W. Wilmore, Cleon W. Goodwin, Laudia A. Zitzka, Leonard Wartofsky, Kenneth D. Burman, Arthur D. Mason, Basil A. Pruitt

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50 Scopus citations


A prospective study of thyroid function was performed in 25 thermally injured patients. These patients are divided into two groups. The first group contains five patients with greater than 50% burn size studied longitudinally during the first 15 days following thermal injury. Significant suppression of serum concentrations of 3,5,3'-triiodothyronine (T3) and elevation of serum concentrations of 3,3',5'-triiodothyronine (rT3) were seen. The free thyroxine index and serum TSH concentrations remained within the normal range. To assess the clinical significance of these alterations in peripheral thyroid hormone concentrations, a second group of 20 patients was studied. We measured the free serum levels of T4(FT4) and T3(FT3) in ten patients, mean age 34 years, mean burn size 56%, studied during a period of clinical deterioration, and in ten patients of comparable age and burn size who were clinically stable. Both FT4 and T3values were significantly lower in the unstable patients (p < 0.01). All FT3values for the unstable patients (M ± SE), 193 ± 14 pg/dl, were below the normal range for FT3of 230 to 669 pg/dl, and significantly lower than those observed in the stable patients (M ± SE), 430 ± 59 pg/dl (p < 0.001). This correlation of biochemical hypothyroidism with clinical deterioration may have functional significance for the critically ill trauma patient.

Original languageEnglish (US)
Pages (from-to)713-721
Number of pages9
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number9
StatePublished - Sep 1980

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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