Normal free thyroxine in critical nonthyroidal illnesses measured by ultrafiltration of undiluted serum and equilibrium dialysis

Martin I. Surks, K. H. Hupart, C. Pan, L. E. Shapiro

Research output: Contribution to journalArticle

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Abstract

Considerable controversy exists concerning the assessment of thyroidal state in critically ill patients with decreased serum T4 and T3 concentrations, in part because serum free T4 values are often low in such patients no matter what method of measurement is used. We developed an ultrafiltration method to measure free T4 and free T3 in undiluted serum and compared the results with those obtained using a standard equilibrium dialysis method to measure free T4 and T3. In 30 consecutive intensive care unit (ICU) patients, serum free T4 values were similar to or higher than those in 12 normal subjects by both methods in most patients and were clearly distinguishable from those in hypothyroid patients. The serum total T4 concentrations in these patients ranged from 12.9-131.3 nmol/L (mean, 68.2; normal mean, 115.8). Free T4 by equilibrium dialysis was highly correlated with free T4 by ultrafiltration in the ICU group (r = 0.91; P < 0.001). Serum free T3 levels, howevedr, whether measured by equilibrium dialysis or ultrafiltration, were decreased in the ICU patients, confirming other reports of lowered free T3 in critically ill clinically euthyroid patients. Our findings suggest that the use of equilibrium dialysis of undiluted serum or ultrafiltration to measure serum free T4 concentrations will distinguish euthyroid hypothyroxinemic ICU patients from those with hypothyroidism.

Original languageEnglish (US)
Pages (from-to)1031-1039
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume67
Issue number5
StatePublished - 1988

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Intensive care units
Dialysis
Ultrafiltration
Thyroxine
Critical Illness
Serum
Intensive Care Units
Hypothyroidism

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Normal free thyroxine in critical nonthyroidal illnesses measured by ultrafiltration of undiluted serum and equilibrium dialysis. / Surks, Martin I.; Hupart, K. H.; Pan, C.; Shapiro, L. E.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 67, No. 5, 1988, p. 1031-1039.

Research output: Contribution to journalArticle

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