MYXEDEMA COMA

y a major complication of HYPOTHYROIDISM

y a life-threatening condition in which patients

with underlying thyroid dysfunction exhibit exaggerated manifestations of hypothyroidism

y an extremely rare condition with a mortality rate

approaching 100%.

y Precipitating factors may include:

infection, trauma, surgery, stroke or CNS depressants.

failure,

y It can be brought on by stress as

from surgery or infection or by noncompliance with thyroid treatment

y Characterized by a drastic decrease in

metabolic rate, hypoventilation leading to respiratory acidosis, hypothermia and hypotension.

y Hypothyroidism depresses metabolic rate,

thus seriously affecting all body systems.

ASSESSMENT
y Hypothermia y Hypotension y Hypoventilation y Decreased mental y Hyporeflexia y Bradycardia y Hypoglycaemia y Respiratory failure y Coma

function
y Profound fatigue

PATIENT MANAGEMENT
y Administer thyroid hormones as ordered. y Levothyroxine: given at 50-100 mcg IV

every 6-8 hours for 24 hours, followed by a daily dose of 50-100 mcg IV until oral agents can be tolerated.

PATIENT MANAGEMENT
y Corticosteroids may also be administered.

Indicated for patients who receive a loading dose bolus of levothyroxine.

y Institute passive rewarming method. A

thermal blanket may be necessary to increase body temperature, Use cautiously, rewarming may cause vasodilation and hypotension.