ArticleIntensive care medicine2010
Secondary adrenal insufficiency in the acute phase of pediatric traumatic brain injury.
Article in Intensive care medicine, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 17 citations in OpenAlex.
- Navigating anterior pituitary dysfunction after traumatic brain injury: mechanisms, diagnosis, and management.Acta neurologica Belgica · 2025Review
- Acute neuroendocrine changes after traumatic brain injury.Brain & spine · 2024Review
- An Approach to Traumatic Brain Injury-Related Hypopituitarism: Overcoming the Pediatric Challenges.Diagnostics (Basel, Switzerland) · 2023Article
- Dynamics and prognostic value of the hypothalamus-pituitary-adrenal axis responses to pediatric critical illness and association with corticosteroid treatment: a prospective observational study.Intensive care medicine · 2020Observational
- Central adrenal insufficiency following traumatic brain injury: a missed diagnosis in the critically injured.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2017Article
- The effects of repeat traumatic brain injury on the pituitary in adolescent rats.Journal of neurotrauma · 2013Article
- Year in review in Intensive Care Medicine 2010: III. ARDS and ALI, mechanical ventilation, noninvasive ventilation, weaning, endotracheal intubation, lung ultrasound and paediatrics.Intensive care medicine · 2011Article
- Pituitary and/or hypothalamic dysfunction following moderate to severe traumatic brain injury: Current perspectives.Indian journal of endocrinology and metabolismReview
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA high incidence of secondary adrenal insufficiency (AI) has been reported several months after a traumatic brain injury (TBI) in pediatric patients. Data from studies in adults suggest that AI may occur during the acute phase of TBI, with potential negative effects in the management of these vulnerable patients. The aim of this study was to describe the prevalence and the characteristics of AI in the acute phase of pediatric TBI.
methodsAdrenal function was systematically evaluated in patients admitted to the pediatric intensive care unit following a TBI. Serial measurements of cortisol (9 samples) and adrenocorticotropic hormone (ACTH) were drawn from the second morning to the third morning post admission. Secondary AI was defined as all cortisols < 200 nmol/l (6 μg/dl) with ACTH < 12 pmol/l.
resultsTwenty-eight patients (2-15 years old) were evaluated. Secondary AI occurred in ten (36%) patients. AI was more frequent in patients with intracranial hypertension (p < 0.05). Patients with AI required longer mechanical ventilation (p < 0.05), and a non-significant trend for a higher Pediatric Logistic Organ Dysfunction score (p = 0.09) and greater norepinephrine dose (p = 0.11) was observed.
conclusionsSecondary AI is frequent during the acute phase of pediatric TBI, particularly when intracranial hypertension is present. Systematic assessment of pituitary function after TBI appears to be essential. A randomized clinical trial is warranted to evaluate the benefits of hormonal replacement therapy in TBI patients with AI.
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