Download Thyroid Storm - Wellington ICU

Survey
yes no Was this document useful for you?
   Thank you for your participation!

* Your assessment is very important for improving the work of artificial intelligence, which forms the content of this project

Document related concepts
no text concepts found
Transcript 
Thyroid Storm
13/5/11
FANZCA Notes
CLINICALLY
-
life threatening exacerbation of hyperthyroid state with 1 or more organ dysfunction
6-24 hours post surgery
fever
sweating
HR >140/min
coma
nausea and vomiting
diarrhoea
MANAGEMENT
Supportive
-
IVF (glucose)
cooling cares
paracetamol (no NSAIDS or asprin -> displaces thyroxine from proteins)
propanolol increments (1mg IV) or esmolol boluses -> infusion (50-100mcg/kg/min)
Specific
- hydrocortisone 200mg IV QID (adrenal insufficiency + decreases T4 release and
conversion)
- propylthiouracil (1g load PO -> 250mg QID to inhibit thyroid hormone release and decrease
peripheral conversion from T4-T3)
- after blockade by propylthiouracil give sodium iodide or potassium iodide or Lugol’s iodine
Jeremy Fernando (2011)
Related documents