Neuroendocrine function following traumatic brain injury and subsequent intensive care treatment: A prospective longitudinal evaluation

Andrea Kleindienst, Georg Brabant, Christoph Bock, Christiane Maser-Gluth, Michael Buchfelder

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Neuroendocrine dysfunction following traumatic brain injury (TBI) has been described extensively. However, few studies are longitudinal and most lack subtle radiological, clinical, and repetitive endocrine assessment in the acute phase. Accordingly, we prospectively assessed neuroendocrine function in 71 patients after TBI. Injury was documented by a computed tomography (CT). During the first week, critical clinical data (Glasgow Coma Score, APACHE score), treatment variables such as duration of analgosedation for mechanical ventilation, were related to basal pituitary function. More than 2 years later, a subgroup of patients was re-evaluated using dynamic testing with ACTH and GHRH-arginine tests. The Pearson's correlation analysis and Mann-Whitney rank sum test for group differences were used for statistical analysis. None of the CT findings predicted neuroendocrine dysfunction following TBI. The adaptive response to critical illness with significantly elevated cortisol levels on admission and decreased levels thereafter in patients ventilated for more than 24h (p
    Original languageEnglish
    Pages (from-to)1435-1446
    Number of pages11
    JournalJournal of neurotrauma
    Volume26
    Issue number9
    DOIs
    Publication statusPublished - 1 Sept 2009

    Keywords

    • Critical illness
    • Endocrine dysfunction
    • Pituitary
    • Traumatic brain injury

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