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Intensive Care Medicine

Published in:

01-08-2005 | Review

Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury

Authors: Ioanna Dimopoulou, Stylianos Tsagarakis

Published in: Intensive Care Medicine | Issue 8/2005

Abstract

Background

A significant number of studies have shown that critically ill patients with brain injury (BI) frequently exhibit abnormal pituitary hormonal responses during the immediate postinjury period.

Discussion

The elucidation of endocrine alterations depends on the criteria used, the diagnostic tests applied, and the timing of testing in relation to BI. The pattern of the detected hormonal abnormalities shows considerable variability. Altered endocrine responses are due mostly to hypothalamic changes rather than to pituitary dysfunction. Several studies have examined the correlation between hormonal alterations and BI severity, but the results are inconsistent. Furthermore, it remains currently unclear whether and how pituitary abnormalities adversely affect the clinical course of BI patients during the period of critical illness. On the basis of current knowledge, with the exception of clinically significant relative adrenal deficiency and diabetes insipidus, the other endocrine alterations do not seem to require any therapeutic intervention in severely ill BI patients. It is also uncertain whether hormonal abnormalities detected in the early post-BI period persist for the rest of these patients’ lives.

Conclusions

In view of current evidence indicating a high incidence of pituitary dysfunction even years following BI it is recommended that repetition of endocrine evaluation should be performed during the rehabilitation phase in all patients.

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Title: Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury
Authors: Ioanna Dimopoulou
Stylianos Tsagarakis
Publication date: 01-08-2005
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 8/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-2689-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hypothalamic-pituitary dysfunction in critically ill patients with traumatic and nontraumatic brain injury

Abstract

Background

Discussion

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Discussion

Conclusions

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