Efficacy of Thyroid Hormone Replacement for Secondary Hypothyroidism Following Intracerebral Hemorrhage

Launched by PEKING UNION MEDICAL COLLEGE HOSPITAL · Apr 7, 2024

Keywords

ClinConnect Summary

This clinical trial is studying whether thyroid hormone replacement therapy can help improve outcomes for patients who have experienced a spontaneous intracerebral hemorrhage (a type of stroke caused by bleeding in the brain) and have low levels of thyroid hormones. Researchers are particularly interested in patients who have low levels of triiodothyronine (T3) or thyroxine (T4), which are important hormones for the body's metabolism and energy levels. Low thyroid hormone levels in critically ill patients can predict a worse recovery, so this study aims to see if giving these hormones back to patients can make a difference in their recovery.

To be eligible to participate, patients need to be between 18 and 80 years old, admitted to the Neurological Intensive Care Unit, and have specific low thyroid hormone levels within a week of their stroke. Participants will be closely monitored to assess the safety and effectiveness of the hormone therapy they receive. It's important to know that this study is still recruiting participants, and it aims to shed light on whether hormone therapy can improve the recovery of patients with serious brain injuries and low thyroid function.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Admittance of neurocritical patients to the Neurological Intensive Care Unit (NICU) with a Glasgow Coma Scale (GCS) score of 3-8 and supratentorial hematoma volume \>30 ml. The disease is limited to spontaneous intracerebral hemorrhage (supratentorial brain parenchyma, with or without hematoma rupture into the ventricle).
• • 2. Age: 18-80 years old.
• • 3. Onset within 24 hours.
• • 4. Free T3 \< 1.80 pg/ml or free T4 \< 0.81 ng/dl within 7 days of onset, with or without TSH \< 0.38 μIU/ml. (Specifically according to the critical values of different center laboratories' abnormal ranges).
• • 5. Emergency head CT scan completed within 24 hours of onset.
• Exclusion Criteria:
• • 1. Organic thyroid lesions (subacute thyroiditis, chronic thyroiditis, post-thyroidectomy, thyroid radiation, hyperthyroidism), history of thyroid hormone oral replacement therapy within the past month.
• • 2. Sella region lesions.
• • 3. Baseline CT indicates irreversible brain herniation, expected survival period \<30 days.
• • 4. Severe systemic multiple injuries outside the nervous system.
• • 5. Pregnant women.
• • 6. Acute or chronic heart failure, arrhythmias, myocardial disease.
• • 7. Only TSH levels decrease while free T3 and free T4 levels remain normal.