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: 8174477
• 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: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2010-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8174477
• 关键词: Accounting; Acute; Adrenal gland hypofunction; Caring; Case Study; Cephalic; Cerebrovascular Circulation; Child; Childhood; Childhood Injury; 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.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目和 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 在治疗患有创伤性脑损伤 (TBI) 的儿科患者时很少考虑垂体功能。鉴于垂体位于蝶鞍内且血管供应脆弱，TBI 对垂体功能构成重大风险。持续损伤的机制可能是由直接机械创伤或与休克或颅内高压相关的低脑血流量状态引起的。许多病例报告指出，颅脑损伤后儿童的下丘脑-垂体轴（HPA）出现异常，无论是围产期还是意外或非意外创伤。目前还没有关于急性创伤后激素缺乏和相关危险因素的发生的前瞻性研究。这是一项试点研究，旨在检查患有任何病因的中度和/或重度 TBI 的儿童中未被识别的继发性或三发性急性肾上腺功能不全 (AAI) 的发生情况。为了解释荷尔蒙应激反应，将 TBI 儿童与颅外损伤儿童的对照组进行比较。将对意外和非意外头部外伤患者进行二次评估。为了进行疾病严重程度比较，计算所有参与研究的儿童的 PRISM（儿童死亡风险）分数。将采用评分系统来量化风险因素，并尝试确定得出的评分与 AAI 存在之间的关系。