Yamamoto T
Endocrinol Jpn. 1984 Dec;31(6):769-75. doi: 10.1507/endocrj1954.31.769.
Three male patients (aged 41, 71 and 65 years) with untreated severe hypothyroidism of long duration were in a state of coma. This had been preceded by respiratory symptoms accompanied by hypoxemia and hypercapnea. There were also various chest radiographic findings. All the patients were treated with mechanical ventilatory assistance, circulatory support and i. v. administration of high doses of l-triiodo-thyronine (T3) during the early period of treatment. None of the patients showed any serious cardiac ill-effects immediately or a few days following the intravenous administration of T3. In spite of the stabilisation of vital signs and improvement in arterial oxygenation, the patients remained in a comatous or semicomatous state for the first few days. During the second week, the condition of their lungs deteriorated and prolonged respiratory failure ensued with fever, rales, excessive bronchial secretion, homogeneous densities in the chest radiograms and persistent hypoxemia even though mechanical ventilatory treatment was continued. The implications of this delayed respiratory failure during the treatment of myxedema coma are discussed.
三名患有未经治疗的长期严重甲状腺功能减退症的男性患者（年龄分别为41岁、71岁和65岁）处于昏迷状态。在此之前，他们出现了伴有低氧血症和高碳酸血症的呼吸道症状。胸部X线检查也有各种表现。所有患者在治疗初期均接受了机械通气辅助、循环支持以及静脉注射大剂量的左旋三碘甲状腺原氨酸（T3）。在静脉注射T3后，没有一名患者立即或在几天内出现任何严重的心脏不良影响。尽管生命体征稳定且动脉氧合改善，但患者在最初几天仍处于昏迷或半昏迷状态。在第二周，他们的肺部状况恶化，尽管继续进行机械通气治疗，但仍出现了持续发热、啰音、支气管分泌物过多、胸部X线片呈现均匀密度以及持续低氧血症等情况，继而导致呼吸衰竭延长。本文讨论了黏液性水肿昏迷治疗期间这种延迟性呼吸衰竭的影响。
