الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
Abstract
Euthyroid sick syndrome (also known as non-thyroidal illness syndrome) can be described as abnormal findings on thyroid function tests that occur in the setting of a non-thyroidal illness (NTI), without preexisting hypothalamic-pituitary and thyroid gland dysfunction. After recovery from an NTI, these thyroid function test result abnormalities should be completely reversible, study of euthyroid sick syndrome in burn patients. (van den Berghe, 2001).
Some authors propose that serum thyroid hormone abnormalities are due to inhibition of thyroid hormone binding to proteins, thus preventing tests from appropriately reflecting free hormone levels. This binding inhibitor can be present both in the serum and in body tissues and might inhibit uptake of thyroid hormones by cells or prevent binding to nuclear T3 receptors, thus inhibiting the action of the hormone. Thyroid function test results in both sexes are affected equally in NTI. (Lee and Farwell 2016)
NTI can affect people at any age. The usual aging process appears to influence the responsiveness of various tissues to thyroid hormone. Because systemic chronic illnesses are common in individuals of an advanced age, altered metabolism might be responsible for abnormal findings on thyroid function tests in elderly patients experiencing chronic illnesses (Chopra et al., 1997).
The metabolic response to trauma in humans has been defined in 3 phases:
1. Ebb phase or decreased metabolic rate in early shock phase,
2. Flow phase or catabolic phase,
3. Anabolic phase (if the tissue loss can be replaced by re-synthesis once the metabolic response to trauma is stopped) (Jan and Lowry, 2010).
In the study from march 2022 to September 2022,88 patients were admitted to study with 44 burn case with ESS and 44 burn case without ESS according to inclusion and exclusion criteria in Burn ICU in Ainshams hospital university
Inclusion Criteria
Patients admitted to burn ICU with:
1- Between 21% TBSA and 50%
2- More than 18 years old with any type of burn between 21% TBSA and 50%
Exclusion criteria
1. Pregnancy within the previous 6 months
2. patient with previous history of thyroid disease
3. patient with severe renal or hepatic dysfunction
4. History of chemotherapy or radiotherapy in the last 6 months
5. Suspicion of underlying hypothalamic or pituitary disease
The results showed that the group with ESS are more associated with higher rate of morality, hospital stay and more poor prognosis with worse APACHE score levels compared to the burn group with ESS.
The study showed that using APACHE score with free T3 levels measurements are more accurate in detecting morality in burn ICU patient.
CONCLUSION
The study demonstrated that ESS are more associated with higher rate of morality, hospital stay and more poor prognosis with worse APACHE score levels.
RECOMMENDATIONS
Since the mechanism of sick euthyroid syndrome is common in critically ill patients, especially burn patients, Therefore more and more studies should be done for the better evaluation of T3 function as prognostic value in burn patient beside APACHE score.