What are the potential complications of myxoedema coma that I should monitor for during management?

Potential complications of myxoedema coma that should be monitored during its management include:

• Respiratory failure: Due to hypoventilation and decreased respiratory drive, patients may develop respiratory insufficiency requiring ventilatory support.
• Cardiovascular instability: Bradycardia, hypotension, and decreased cardiac output can occur, increasing the risk of heart failure and shock.
• Hypothermia: Profound low body temperature is common and requires careful monitoring and gradual rewarming.
• Hyponatraemia and electrolyte imbalances: These can result from impaired renal function and altered water metabolism.
• Infections: Patients are at increased risk of sepsis due to impaired immune function and altered consciousness.
• Altered mental status and coma: Progression of neurological impairment necessitates close neurological monitoring.
• Hypoglycaemia: Low blood glucose levels may occur and should be monitored and corrected promptly.

Monitoring for these complications is critical to guide supportive care and improve outcomes in myxoedema coma management.

Note: While the provided NICE guideline excerpts focus on hypothyroidism management broadly, these complications are well-recognised in clinical practice and standard endocrine references for myxoedema coma management. The NICE guideline NG145 does not explicitly list myxoedema coma complications but covers hypothyroidism assessment and management principles relevant to severe cases ¹.