EARLY HYPOPITUITARISM AFTER TRAUMATIC BRAIN INJURY IN CHILDREN

儿童脑外伤后早期垂体机能减退

• 批准号: 7952228
• 负责人: CATHERINE S MAO
• 金额: $ 0.4万
• 依托单位: LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-12-01 至 2009-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7952228
• 关键词: Accounting; Acute; Adrenal gland hypofunction; Caring; Case Study; Cephalic; Cerebrovascular Circulation; Child; Childhood; Childhood Injury; Clinical Research; Computer Retrieval of Information on Scientific Projects Database; Control Groups; Craniocerebral Trauma; Etiology; Evaluation; Funding; Gland; Grant; Hormonal; Hypopituitarism; Injury; Institution; Intracranial Hypertension; Location; Mechanics; Non-accidental; Patients; Pilot Projects; Pituitary Gland; Prospective Studies; Research; Research Personnel; Resources; Risk; Risk Factors; Severity of illness; Shock; Source; System; TBI Patients; Trauma; Traumatic Brain Injury; United States National Institutes of Health; Vascular blood supply; biological adaptation to stress; hypothalamic pituitary axis; mortality

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Pituitary function is rarely considered in the care of pediatric patients with traumatic brain injury (TBI). TBI poses signnificant risk to pituitary function given the gland's location within the sella tucica and a vulnerable vascular supply. The mechanism by which damage may be sustained may result from direct mechanical trauma, or low cerebral blood flow states associated with shock or intracranial hypertension. Numerous case reports have noted abnormalities in the hypothalamic-pituitary axis (HPA) in children after craniocerebral injury whether it is acquired perinatally or from accidental or non-accidental trauma. There have been no prospective studies regarding the occurrence of acute post-traumatic hormonal deficits and associated risk factors. This is a pilot study examining the occurrence of unrecognized secondary or tertiary acute adrenal insufficiency (AAI) in children who are subjected to moderate and/or severe TBI of any etiology. To account for the homronal stress response, the TBI children will be compared to a control group of children with extra-cranial injuries. A secondary evaluation will be made between accidental and non-accidental head trauma patients. For severity of illness comparison PRISM (Pediatric Risk of Mortality) scores are calculated for all children entered into the study. A scoring system will be employed to quantify risk factors, and an attempt to detrmine a relationship between the derived score and presence of AAI will be undertaken.

该副本是利用众多研究子项目之一 由NIH/NCRR资助的中心赠款提供的资源。子弹和 调查员（PI）可能已经从其他NIH来源获得了主要资金， 因此，可以在其他清晰的条目中表示。列出的机构是 对于中心，这不一定是调查员的机构。 在儿科患者脑损伤（TBI）的儿科患者的护理中很少考虑垂体功能。鉴于塞拉图卡（Sella Tucica）的位置和脆弱的血管供应，TBI对垂体功能构成了明显的风险。可能受到损害的机制可能是由直接的机械创伤引起的，或与休克或颅内高血压相关的低脑血流状态。大量病例报告指出，无论是围绕颅脑损伤还是因偶然或非事故创伤，颅骨损伤后儿童下丘脑垂体（HPA）异常。关于急性创伤后激素缺陷和相关危险因素的发生的前瞻性研究。这是一项试点研究，研究了未经识别的次级或高等急性肾上腺功能不全（AAI）的发生，这些儿童受到任何病因的中度和/或严重TBI的发生。为了考虑人义压力反应，将将TBI儿童与颅外伤害的对照组进行比较。意外和非事故的头部外伤患者将进行次要评估。为了使疾病的严重程度比较棱镜（死亡率的小儿风险）分数均计算为研究的所有儿童。将采用评分系统来量化风险因素，并尝试在派生得分和AAI的存在之间进行衰落。