TJDoc7

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Understand the need for for cortisol, surfactant...diagnosing, managing...but looking for a simple explanation (can't find def. online, mostly jorunal explanations which frankly...don't have time to read right now), what is the mechanism/rationale for baby w/nrds getting thyroxine? Not sure if this is just wayyyy to easy of an explanation and i'm overthinking it (plus late), but anyone have firm grasp on this?
 

VanBrown

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I don't really see any reason to give a neonate T4... standard treatment is synthetic surfactant and CPAP. I wouldn't doubt that a premature baby might have low serum levels of T4/3 but that doesn't warrant treatment.
 

cpants

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I don't really see any reason to give a neonate T4... standard treatment is synthetic surfactant and CPAP. I wouldn't doubt that a premature baby might have low serum levels of T4/3 but that doesn't warrant treatment.
If the baby is hypothyroid it does warrant treatment, but doesn't have anything to do with RDS treatment.
 

oldbearprofessor

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Understand the need for for cortisol, surfactant...diagnosing, managing...but looking for a simple explanation (can't find def. online, mostly jorunal explanations which frankly...don't have time to read right now), what is the mechanism/rationale for baby w/nrds getting thyroxine? Not sure if this is just wayyyy to easy of an explanation and i'm overthinking it (plus late), but anyone have firm grasp on this?
Therapy with thyroid hormone is not an accepted aspect of the management of hyaline membrane disease.

I don't really see any reason to give a neonate T4... standard treatment is synthetic surfactant and CPAP. I wouldn't doubt that a premature baby might have low serum levels of T4/3 but that doesn't warrant treatment.
Just to clarify, surfactants used in the US are mostly not the synthetic ones but are the animal-derived ones and they must be delivered via an endotracheal tube so nasal CPAP can't be used for their delivery. After dosing, the baby can be extubated to nasal CPAP.
 

TJDoc7

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thanks for responses...I agree with everything you all said (as I never even heard of thyroxine being used in that way, unless of course as stated above, the baby was hypothyroid)...but am currently studying for step 1, and am trying to see if there is some sort of "theoretical" moa w/thyroxine/nrds that I should be aware (despite what is actually used in practice).

According to 2010 first aid, p.509 (again, not saying any of you are wrong), it clearly states "neonatal respiratory distress syndrome...tx: maternal steroids before birth, art. surfactant, thyroxine". 100% know that first aid is NOT a reliable source to judge what is/isn't acceptable in clinical practice/real world, just trying to figure out why thyroxine would be there (in terms of a step 1 question)...maybe theoretical treatment, some kind of other mechanism? Any thoughts?

Thanks.

p.s. on internet only thing i've come across is studies of infants treated w/and w/o thyroxine + standard therapy...and they all say there was no benefit to using the thyroxine...so again...know it isn't used/helpful...but WHY is that even a thought to try it (the problem i'm trying to figure out).
 
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If you've already taken your boards then you don't need this but thyroxine and prolactin stimulate surfactant synthesis. Probably not used in practice because the papers I looked at said there's no conclusive evidence but probably something Step 1 may throw on there.