Myxedema coma

Mitchell-Brown, Fay; Gates, C. R.

doi:10.1097/01.nurse.0000832344.83659.a4

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…18 Thus, the American Thyroid Association recommends treatment with T4 alone or combination therapy with both T4 and T3. 19 In patients with MC, there is usually edema of the intestinal wall, which impedes drug absorption. 20 Therefore, parenteral administration of T3 and T4 is generally recommended.…”

Section: Discussionmentioning

confidence: 99%

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Severe hypoxemia after extubation secondary to myxedema coma: a case report

Sun,

Peng,

Huaguo

et al. 2023

J Int Med Res

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Myxedema coma is a rare and life-threatening endocrine emergency characterized by abnormalities in multiple organ systems. A 32-year-old woman with prolonged undiagnosed severe hypothyroidism was referred to our hospital owing to lower abdominal pain and menopause for more than 3 months. She underwent exploratory laparotomy and induced abortion under general anesthesia, and developed severe hypoxemia after extubation. She was diagnosed with myxedema coma, and was subsequently discharged with a good prognosis following treatment. This case suggests that myxedema coma should be considered a potential etiology of peri-operative hypoxemia. The findings in this case emphasize the importance of anesthesiologists’ comprehensive understanding of myxedema coma. Prompt diagnosis followed by treatment is essential to reduce the mortality rate associated with this condition.

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Section: Discussionmentioning

confidence: 99%

“… 18 Thus, the American Thyroid Association recommends treatment with T4 alone or combination therapy with both T4 and T3. 19 …”

Section: Discussionmentioning

confidence: 99%

Severe hypoxemia after extubation secondary to myxedema coma: a case report

Sun,

Peng,

Huaguo

et al. 2023

J Int Med Res

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“…Myxedema coma is treated mainly with thyroid hormones. (20). For the management of myxedema coma, corticosteroids should be administered intravenously at suitable stress doses before levothyroxine is given.…”

Section: Myxedema Coma and Thyroid Stormmentioning

confidence: 99%

Corticosteroids Usage in the Intensive Care Unit: Specific Recommendations Based on Recent Evidence

AWAD,

ABDELBAKY,

SHOAIB

et al. 2023

Pak J Intens Care Med

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Corticosteroids are a class of drugs that mimic the effects of cortisol, a hormone naturally produced by the adrenal glands. They exert a wide range of effects on the body's immune, metabolic, and inflammatory responses. In the context of critically ill patients in the intensive care unit (ICU), corticosteroids are frequently utilised due to their potent anti-inflammatory and immunosuppressive properties. In the ICU setting, corticosteroids are commonly employed to manage various conditions such as severe sepsis, acute respiratory distress syndrome (ARDS), exacerbations of chronic obstructive pulmonary disease (COPD), and adrenal insufficiency. Their mechanism of action involves suppression of pro-inflammatory cytokines, inhibition of leukocyte migration, and stabilisation of cell membranes, among other effects. The choice of corticosteroid, dosing regimen, and duration of therapy in the ICU depends on the specific clinical condition being treated and individual patient factors. For instance, corticosteroids such as hydrocortisone are often administered to attenuate the systemic inflammatory response and improve hemodynamic stability in the management of septic shock. Dosing may vary but commonly involves an initial bolus followed by continuous infusion or intermittent dosing. In ARDS, corticosteroids may reduce lung inflammation and prevent further tissue damage. Methylprednisolone is a commonly utilised corticosteroid in this context, with dosing typically initiated at a high dose and then tapered gradually based on clinical response. For patients with exacerbations of COPD, corticosteroids help to reduce airway inflammation and improve lung function. Oral or intravenous corticosteroids such as prednisone or methylprednisolone are often prescribed for a short duration during exacerbations. In cases of adrenal insufficiency, corticosteroid replacement therapy is essential to restore physiological cortisol levels and prevent adrenal crisis. Hydrocortisone is the corticosteroid of choice in this scenario, with dosing adjusted based on the degree of adrenal dysfunction and stress level. Despite their efficacy, corticosteroids are associated with a range of potential adverse effects, including immunosuppression, hyperglycemia, fluid retention, electrolyte abnormalities, and increased risk of infection. Therefore, carefully monitoring patients receiving corticosteroid therapy in the ICU is paramount, with adjustments to minimise risks while optimising therapeutic benefits. In summary, corticosteroids play a crucial role in managing critically ill patients in the ICU, offering potent anti-inflammatory and immunomodulatory effects. However, their use requires careful consideration of the underlying condition, patient characteristics, and potential adverse effects, with dosing and duration tailored to individual needs.

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“…The serum T4 level in MC is typically very low. The serum TSH level may be low, normal, or slightly high, indicating central hypothyroidism, or high, indicating primary hypothyroidism [7]. Despite all the previous notes, many other causes could induce myxedema coma, such as schizophrenia patients treated with lithium carbonate.…”

Section: Introductionmentioning

confidence: 99%

Amiodarone Induced Myxedema Coma: A Systematic Review of Case Reports

Alnaeem

Mansour

Alwahsh

et al. 2023

Preprint

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Objective The current systematic review examined whether elderly patients who received amiodarone were at risk for developing myxedema coma. Methods The Cochrane guidelines were used for a systematic review of Medline (PubMed), Science Direct, CINAHL Cochrane database, and Google Scholar for case reports on the Amiodarone-induced myxedema coma. Results A total of 12 case reports were found to meet the determined inclusion criteria. Patients who received amiodarone highly risk of developing myxedema coma. Case reports showed that patients received 100–200 mg of amiodarone orally and developed bradycardia and hypothermia with elevation in thyroid stimulating hormone. Most patients were treated with levothyroxine and hydrocortisone medication upon diagnosis. Conclusion The various possible causes of Myxedema coma make diagnosis difficult. Through clinical symptoms and serum TSH, the diagnosis could be confirmed. Amiodarone-induced Myxedema coma was successfully treated with levothyroxine and glucocorticoids.

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Myxedema coma

Abstract: Myxedema coma (MC) develops from a long-standing, unrecognized, or untreated hypothyroidism. This article discusses the pathophysiology, clinical manifestations, treatment, and nursing considerations for patients with MC.

Cited by 4 publications

References 4 publications

Severe hypoxemia after extubation secondary to myxedema coma: a case report

Severe hypoxemia after extubation secondary to myxedema coma: a case report

Corticosteroids Usage in the Intensive Care Unit: Specific Recommendations Based on Recent Evidence

Amiodarone Induced Myxedema Coma: A Systematic Review of Case Reports

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