{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T10:41:43Z","timestamp":1775472103793,"version":"3.50.1"},"reference-count":32,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T00:00:00Z","timestamp":1555977600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Several respiratory abnormalities can be present in primary hypothyroidism and can be reversed with adequate hormone treatment. However, the role of thyroid hormone replacement therapy on the respiratory system in patients with nonthyroidal illness syndrome is still unclear. This physiologic study evaluated the effect of thyroid hormone treatment on respiratory muscle function in subjects with nonthyroidal illness syndrome and while on mechanical ventilation. The primary end point was neuromechanical efficiency, which provides an estimate of the efficiency of diaphragmatic contraction. Secondary end points were the transdiaphragmatic pressure-time product and the swing of the electrical activity of the diaphragm, which reflect the work of breathing and inspiratory effort, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Fifteen subjects on mechanical ventilation for \u226548 h and with a diagnosis of nonthyroidal illness syndrome who had a failed spontaneous breathing trial, received intravenous triiodothyronine. The hormone was administered as an intravenous bolus of 0.4 \u03bcg\/kg triiodothyronine, followed by continuous perfusion at 0.6 \u03bcg\/kg for 24 h. Neuromechanical efficiency was calculated as the ratio between the drop in airway pressure during an expiratory occlusion and the corresponding electrical activity of the diaphragm peak. Recordings were taken at baseline and after 3, 6, and 24 h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After study completion, free triiodothyronine serum concentrations increased in all the subjects (mean \u00b1 SD increase, 0.84 \u00b1 0.34 pg\/mL). Neuromechanical efficiency showed no significant changes throughout the study (mean \u00b1 SD baseline, 1.40 \u00b1 0.87 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O\/\u03bcV; 3 h, 1.28 \u00b1 0.64 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O\/\u03bcV; 6 h, 1.33 \u00b1 0.87 cm H2O\/\u03bcV; 24 h, 1.41 \u00b1 0.96 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O\/\u03bcV). Similarly, no variations in transdiaphragmatic pressure-time product per min (mean \u00b1 SD baseline, 238.1 \u00b1 124 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O \u00d7 s\/min; 3 h, 242.5 \u00b1 140.3 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O \u00d7 s \/min; 6 h, 247.5 \u00b1 161.7 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O \u00d7 s\/min; 24 h, 281.2 \u00b1 201.2 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O \u00d7 s\/min) or swing of electrical activity of the diaphragm (mean \u00b1 baseline, 20.9 \u00b1 13.1 \u03bcV; 3 h, 17.2 \u00b1 8.3 \u03bcV; 6 h, 17.4 \u00b1 11.3 \u03bcV; 24 h, 20.3 \u00b1 13.7 \u03bcV) were observed during hormone administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In the subjects on mechanical ventilation who were admitted to the ICU with nonthyroidal illness syndrome, thyroid hormone replacement treatment did not yield any benefit on respiratory muscle function when assessed by neuromechanical efficiency, which indicated that, in these subjects restoring normal levels of serum thyroid hormones is debatable. (ClinicalTrials.gov registration NCT03157466.)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.06770","type":"journal-article","created":{"date-parts":[[2019,4,23]],"date-time":"2019-04-23T17:45:14Z","timestamp":1556041514000},"page":"1199-1207","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Effects of Thyroid Hormone Treatment on Diaphragmatic Efficiency in Mechanically Ventilated Subjects With Nonthyroidal Illness Syndrome"],"prefix":"10.1177","volume":"64","author":[{"given":"Giuseppe","family":"Bello","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgia","family":"Spinazzola","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Giammatteo","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Montini","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennaro","family":"De Pascale","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Bisanti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria G","family":"Annetta","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Troiani","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze di Laboratorio e Infettivologiche; UOC di Chimica, Biochimica e Biologia Molecolare; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Chimica, Biochimica e Biologia Molecolare; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche; UOC di Endocrinologia e Diabetologia; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Endocrinologia e Diabetologia; Universit\u00e0 Cattolica del Sacro Cuore, Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Pontecorvi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Gastroenterologiche, Endocrino-Metaboliche e Nefro-Urologiche; UOC di Endocrinologia e Diabetologia; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Endocrinologia e Diabetologia; Universit\u00e0 Cattolica del Sacro Cuore, Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariano A","family":"Pennisi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio","family":"Conti","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione; UOC di Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica; Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma; Istituto di Anestesia e Rianimazione; Universit\u00e0 Cattolica del Sacro Cuore Largo A Gemelli 8, 00168 Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,4,23]]},"reference":[{"issue":"11","key":"e_1_3_2_2_2","first-page":"919","article-title":"The role of thyroid dysfunction in the critically ill: a review of the literature","volume":"76","author":"Bello G","year":"2010","unstructured":"Bello G, , Ceaichisciuc I, , Silva S, , Antonelli M. The role of thyroid dysfunction in the critically ill: a review of the literature. 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New modes of mechanical ventilation: proportional assist ventilation, neurally adjusted ventilatory assist, and fractal ventilation. 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Nonthyroidal illness syndrome in severe chronic obstructive pulmonary disease exacerbations in the elderly. Turk J Geriatr 2016; 19(2):67\u201373. Available at http:\/\/geriatri.dergisi.org\/uploads\/pdf\/pdf_TJG_928.pdf."},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199007000-00004"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-46-1-77"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(76)92958-5"},{"key":"e_1_3_2_33_2","first-page":"20","article-title":"Impact of prolonged assisted ventilation on diaphragmatic efficiency: NAVA versus PSV","volume":"5","author":"Di Mussi R","year":"2016","unstructured":"Di Mussi R, , Spadaro S, , Mirabella L, , Volta CA, , Serio G, , Staffieri F, et al. Impact of prolonged assisted ventilation on diaphragmatic efficiency: NAVA versus PSV. 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