The Internet Book of Critical Care Podcast IBCC Episode 23 - Thyroid Storm
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Feb 11, 2019 In this podcast, the diagnosis and management of thyroid storm are discussed. The episodes cover presentations, diagnostic criteria, management strategies including the controversial use of beta-blockade, and cardiovascular manifestations and stabilization. Risks of using beta blockers are also addressed.
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When to Suspect Thyroid Storm
- Always consider thyroid storm in patients with known hyperthyroidism getting sick or unexplained severe atrial fibrillation.
- Include it in differential for delirium, psychosis, fever, or sepsis without a clear source.
Lab Limits in Thyroid Storm Diagnosis
- Lab thyroid hormone levels don't differentiate thyroid storm from uncomplicated hyperthyroidism.
- This suggests other factors beyond hormone levels, like inflammation or sympathetic activity, drive thyroid storm.
Use Burch Criteria With Caution
- Use Burch criteria to aid diagnosis but don't rely on it rigidly.
- Always consider alternative causes like infection or other causes of fever and tachycardia.