Myxedema coma

Myxedema Coma:

  • Complication of severe hypothyroidism
  • Signs/symptoms:
    • Change/altered mental status
    • Edema, “puffy face”
    • Hypotension, bradycardia, hypothermia
    • Tachypnea
  • Treatment: Goal is to restore the euthyroid state.
    • Admit to the ICU.
    • ****IV levothyroxine****
      • Initially: IV bolus 200-500 micrograms
      • Daily: 50 – 100 micrograms IV
        • Transition to oral levothyroxine.
      • Supportive care: mechanical ventilation, vasopressors, glucocorticoids
      • Warmed IV fluids
      • Warming blanket
      • Treat underlying precipitating event.

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