OBJECTIVE: To investigate the incidence and type of endocrine abnormalities in critical care patients with traumatic brain injury (TBI) and to examine their relationships to possible predisposing factors. DESIGN: Prospective study. SETTING: General intensive care unit in a university hospital. PATIENTS AND PARTICIPANTS: Thirty-four TBI patients (27 men, 7 women), having a mean age of 37+/-16 years, were studied after weaning from mechanical ventilation. INTERVENTIONS: Baseline endocrine assessment was carried out by measuring cortisol, corticotropin, dehydroepiandrosterone sulfate, free thyroxine, thyrotropin (TSH), testosterone, oestradiol, follicle stimulating hormone (FSH), luteinizing hormone, prolactin, growth hormone and insulin-like growth factor I. Dynamic evaluation was performed by human corticotropin releasing hormone and growth hormone releasing hormone in all patients. Male patients underwent additional investigation with gonadotropin-releasing hormone. Severity of neurological derangement was graded according to Glasgow Coma Scale (GCS), Marshall Computerized Tomographic Classification and intracranial pressure (ICP) levels. MEASUREMENTS AND RESULTS: Eighteen of the 34 patients (53%) had an abnormal result in at least one hormonal axis tested, with cortisol hyporesponsiveness and gonadal dysfunction being equally common, affecting 24% of patients. Endocrine abnormalities were associated with a higher brain CT-scan classification score ( p=0.02). The GCS on admission correlated positively with baseline FSH (r=0.37, p=0.03), peak FSH (r=0.41, p=0.03), testosterone (r=0.44, p=0.02) and TSH (r=0.39, p=0.03). There were no relations between ICP(max) and any baseline or dynamic hormone measurements. CONCLUSIONS: Patients with TBI receiving critical care show changes in their neuroendocrine responses, which depend upon clinical and radiological measures of head injury severity. Most common abnormalities include cortisol hyporesponsiveness and hypogonadism.
OBJECTIVE: To investigate the incidence and type of endocrine abnormalities in critical care patients with traumatic brain injury (TBI) and to examine their relationships to possible predisposing factors. DESIGN: Prospective study. SETTING: General intensive care unit in a university hospital. PATIENTS AND PARTICIPANTS: Thirty-four TBI patients (27 men, 7 women), having a mean age of 37+/-16 years, were studied after weaning from mechanical ventilation. INTERVENTIONS: Baseline endocrine assessment was carried out by measuring cortisol, corticotropin, dehydroepiandrosterone sulfate, free thyroxine, thyrotropin (TSH), testosterone, oestradiol, follicle stimulating hormone (FSH), luteinizing hormone, prolactin, growth hormone and insulin-like growth factor I. Dynamic evaluation was performed by humancorticotropin releasing hormone and growth hormone releasing hormone in all patients. Male patients underwent additional investigation with gonadotropin-releasing hormone. Severity of neurological derangement was graded according to Glasgow Coma Scale (GCS), Marshall Computerized Tomographic Classification and intracranial pressure (ICP) levels. MEASUREMENTS AND RESULTS: Eighteen of the 34 patients (53%) had an abnormal result in at least one hormonal axis tested, with cortisolhyporesponsiveness and gonadal dysfunction being equally common, affecting 24% of patients. Endocrine abnormalities were associated with a higher brain CT-scan classification score ( p=0.02). The GCS on admission correlated positively with baseline FSH (r=0.37, p=0.03), peak FSH (r=0.41, p=0.03), testosterone (r=0.44, p=0.02) and TSH (r=0.39, p=0.03). There were no relations between ICP(max) and any baseline or dynamic hormone measurements. CONCLUSIONS:Patients with TBI receiving critical care show changes in their neuroendocrine responses, which depend upon clinical and radiological measures of head injury severity. Most common abnormalities include cortisolhyporesponsiveness and hypogonadism.
Authors: G Sassolas; F B Chazot; P Jaquet; I Bachelot; P Chanson; C C Rudelli; J P Tauber; H Allannic; J Bringer; N Roudaut; V Rohmer; P Roger; J L Latapie; P Reville; M Leutenegger Journal: Eur J Endocrinol Date: 1999-12 Impact factor: 6.664
Authors: Hagen B Huttner; Ines-Christine Kiphuth; Linda Teuber; Hannes Lücking; Stephan P Kloska; Dimitre Staykov; Joji B Kuramatsu; Christoph Mauer; Lorenz Breuer; Arnd Doerfler; Martin Köhrmann Journal: Neurocrit Care Date: 2013-02 Impact factor: 3.210
Authors: Peter Andrews; Elie Azoulay; Massimo Antonelli; Laurent Brochard; Christian Brun-Buisson; Geoffrey Dobb; Jean-Yves Fagon; Herwig Gerlach; Johan Groeneveld; Jordi Mancebo; Philipp Metnitz; Stefano Nava; Jerome Pugin; Michael Pinsky; Peter Radermacher; Christian Richard; Robert Tasker; Benoit Vallet Journal: Intensive Care Med Date: 2005-01-28 Impact factor: 17.440
Authors: Justin Wagner; Joshua R Dusick; David L McArthur; Pejman Cohan; Christina Wang; Ronald Swerdloff; W John Boscardin; Daniel F Kelly Journal: J Neurotrauma Date: 2010-06 Impact factor: 5.269
Authors: Halil Ulutabanca; Nihal Hatipoglu; Fatih Tanriverdi; Abdülkerim Gökoglu; Mehmet Keskin; Ahmet Selcuklu; Selim Kurtoglu; Fahrettin Kelestimur Journal: Childs Nerv Syst Date: 2013-12-10 Impact factor: 1.475
Authors: Ravi Srinivas; S Danielle Brown; Yue-Fang Chang; Pamela Garcia-Fillion; P David Adelson Journal: Childs Nerv Syst Date: 2009-11-24 Impact factor: 1.475